50-yr old female presents with itchiness and soreness to her left side and upper back. Reports she’s been gardening and believes it may be a spider bite. Felt irritation 3 days ago and intermittent itching. She took OTC Benadryl without benefit. Today she presents with intermittent shooting pain and tingling sensations.

1. What may be the underlying cause (pathophysiology) in this case?  
2. What is your patient’s physical assessment priority? 
3. Based on your physical assessment findings, what are your top 3 differential diagnoses? Include a rationale for each differential.
4. What diagnostic testing, if any, would you use for the most likely primary diagnosis? 
5. Using evidence-based guidelines- what would your initial plan of care be for your patient?  
6. Discuss patient education and follow-up care.

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