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Client is being seen today for a rash that has worsened over the past week. Client reports being under a lot of stress recently with the pregnancy, buying a new home, and continuing to work full-time. Focused assessment reveals painless, dry, rough patches and bumps on the skin primarily the hands, feet, face, neck, and chest. Skin is dry and flaky without plaques, drainage, or swelling. There are no signs of infection. There is facial erythema and some perioral pallor. Blanching of the skin is delayed. Client denies any allergies that may have caused the rash and states they do not have a history of any skin disorders. Client denies having changed any of their detergents, soaps, or creams. They have not changed their routine. They take daily showers; they state they like the water to be very warm and they use regular body soap, no body moisturizers, and they have not been exposed to any type of poison ivy or oak. Client denies any other symptoms except some pruritus for which they have been using over-the-counter (OTC) lotions and diphenhydramine but those do not seem to be working. Vital signs: temperature, 98.8°F (37.1°C); heart rate, 89 beats/min; respiratory rate,
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