What Your Primary Explained for Students (Easy Guide)

This type of question evaluates analytical and critical thinking skills.

What This Question Is About

This question relates to what your primary and requires a structured academic response.

How to Approach This Question

Use appropriate theories and support your answer with clear reasoning.

Key Explanation

This topic involves what your primary. A strong answer should include explanation, application, and examples.

Original Question

What is your primary (one) diagnosis for this patient at this time? (support the decision for your diagnosis with pertinent positives and negatives from the case) Primary diagnosis is Allergic Conjunctivitis. This diagnosis is supported by the following Pertinent positives – redness, itching, tearing, slight light sensitivity, intact vision, history of seasonal allergies Pertinent negatives – denies sore throat, no swollen lymph nodes, no fever, no recent illness Identify the corresponding ICD-10 code. ICD-10 Code is H10.45 Provide a treatment plan for this patient’s primary diagnosis which includes: Medication* Any additional testing necessary for this particular diagnosis* Patient education Referral Mizoguchi et al. (2017) mention that dual activity medications, are first choice medications for the treatment of allergic conjunctivitis because they are easier tolerated and are more effective in providing symptom relief. As such, pharmacological first line treatment of allergic conjunctivitis includes the use of topical Dual Activity medications – medications that contain antihistamines and mast-cell stabilizing agents. Olopatadine 0.2% (ophthalmic solution), 1 gtt in each affected eye once a day would be prescribed for this patient. Additionally, the effects of intranasal steroids on ocular allergic symptoms have been positive (Dupuis et al., 2020). As such, this patient should continue use of his fluticasone proprionate. Olopatadine 0.2% Disp: 1 bottle Sig: Instill 1 drop into each eye daily Refills: 0 (If patient requires a new prescription for this medication) Fluticasone Proprionate Nasal Spray 50 mcg per actuation Disp: 1 bottle Sig: Use 2 sprays in each nostril daily Refills: 0 No additional testing is required at this time since this patient is not experiencing any visual disturbances and no foreign body was observed. Patient education: Avoid allergen Take your medication as prescribed. Wash your hands before and after using this medication. Do not touch the container tip to the eye, lid, or other skin. Tilt your head back and drop medication into each eye. Keep your eyes closed after placing drops and put pressure on the inside corner of the eye to keep the medicine in your eye. Replace bottle cap after using medicine. Referral to Ophthalmology for possible tonometry studies should be submitted. Dupuis et al. 2020, suggests that ophthalmology referral is required because intranasal steroid use can increase the risk of increased ocular pressure. Provide an active problem list for this patient based on the information given in the case. Active Problem List: Allergic Rhinitis Recreational marijuana use Alcohol use Elevated BMI Are there any changes that you would also make to this patient’s overall treatment plan at this time? Must provide an EBM argument for each treatment or testing decision. At this time, there are no treatment changes that I would employ. Provide an appropriate F/U plan. According to the American Optometric Association, follow up should be based on allergic conjunctivitis severity and the potential for ocular morbidity. A mild case requires a follow up in 5-7 days after initiation of treatment. Consequently, follow up for this patient will be scheduled for 1 week to reassess symptoms and evaluate progress. References American Optometric Association (n.d.). Optometric Clinical Practice Guidelines: Care of the patient with Conjunctivitis. Retrieved from https://www.sdeyes.org/docs/CPG-11.pdf (Links to an external site.) Dupuis, P., Prokopich, C. L., Hynes, A., & Kim, H. (2020). A contemporary look at allergic conjunctivitis. Allergy, Asthma, and Clinical Immunology, 16(1), 5-5. https://doi.org/10.1186/s13223-020-0403-9 (Links to an external site.) Mizoguchi, T., Ozaki, M., & Ogino, N. (2017). Efficacy of 0.05% epinastine and 0.1% olopatadine for allergic conjunctivitis as seasonal and preseasonal treatment. Clinical Ophthalmology (Auckland, N.Z.), 11, 1747-1753. https://doi.org/10.2147/OPTH.S141279

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