What side effects might you see with medications given as treatment?
i need the questions answered for the following case studyA 68 year old white female comes to the office for complaints of a worsening rash to the left chest with burning, tingling, pain, and itching over the past 3 days along with fatigue. About 2 days prior to the rash, the area started out just being very painful and “tingling”. The patient then noticed the area was red with just one small “red painful blistery bump” which continued to spread. Patient states “I don’t remember ever having anything like this before”. Her past medical history is significant for Rheumatoid arthritis diagnosed at age 65 and is on immunosuppressing medications. She is up to date on her vaccinations and had flu shot this year. Patient has a history of having chicken pox when she was a child but unsure of exact age. Current medications include:Ibuprofen 400 mg PO every 4-6 hours as needed for painMethotrexate 10 mg Sub-Q injection once a weekPrednisone 7.5 mg PO dailyNature’s Way Alive! Once daily women’s 50+ multivitamin 1 tablet POShe denies any food or medication allergies, any recent new environmental exposure to the affected area (soaps, detergents, lotions, etc.), any shortness of breath, fever, cough, congestion, headache, or chest pain. On examination the patient is alert and oriented to person, place, and time. She is in no apparent distress, not ill appearing, and well nourished. Her blood pressure of 118/80, pulse 72 bpm, respiratory rate 16, temperature 98.2 F. Weight is 61.235 kg, Height is 160 cm, BMI is 23.9, and BSA is 1.65 m2. The skin showed clusters of confluent vesicles only to the left anterior inframammary region. No crusting, flaking, streaking, drainage or puss noted. Questions:What is the most likely diagnosis for this patient and why?What side effects might you see with medications given as treatment? Are their tests that need to be performed for diagnosis or before starting a treatment regimen? If so, what are they, why are they needed?What are the medical considerations for this patient when deciding on a treatment plan and what changes would you make because of them?What would you educate your patient on?
