Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
SUBJECTIVE
Brittany is a 12‐year‐old biracial female in the 7th grade. She presents twice in 1 week to the school‐based health center (SBHC) for stomachaches. At the second visit, in a discussion about nutrition and sleep hygiene, Brittany reports difficulty with falling asleep due to being worried something bad will happen, especially to her mom, as well as disrupted sleep due to nightmares. Brittany reports her family moved homes 3 months ago because “stepdad is gone and isn’t allowed around us anymore.” After the move, Brittany states “I thought I would feel better, but I felt worse instead.” She quit gymnastics because it did not feel fun anymore. She also reports difficulty focusing, which has had a negative impact on her grades. The school counselor also reports recent concerns relating to Brittany’s concentration and her leaving the classroom frequently for breaks. Brittany acknowledges difficulty focusing and that “my mind won’t stop when a room is quiet, so I try to distract myself.” When asked about her thoughts during those times or the content of her distressing dreams, Brittany quietly says “I’m not ready to talk about it.” Her school counselor also notes some recent social isolation and an increasingly more serious nature, and comments that this is a shift for a once “smiley and engaging” student.
Past medical history: Brittany has a past history of gastroesophageal reflux disease (GERD), which has resolved; she no longer takes medications. She denies any history of prior hospitalizations or surgery. She has seen a gastroenterologist in the past but otherwise does not see any specialists nor does she see her primary care provider regularly. She denies any recent weight gain or loss. She denies sexual activity and had a negative PHQ‐9 and CRAFFT as part of her annual screening at the SBHC.
Family history: Her family history is positive for maternal alcohol use and a first‐degree relative with a history of substance use. Paternal history is unknown.
Social history: Brittany is the oldest of 2 siblings, both sisters. Her biological parents divorced when she was 3 years old and her biological father lives several states away. He visits on holidays and occasionally in the summer. Her mother remarried and is currently in a domestically violent relationship with Brittany’s stepfather. All 3 children witnessed ongoing physical and verbal abuse toward the biological mother. As of 3 months ago, Brittany’s stepfather is currently in prison with a no contact order in place for all of the children.
Sleep history: She reports difficulty initiating sleep and waking throughout the night. She gets an average of 6–7 hours nighttime sleep, per self‐report. She will sometimes take a Tylenol PM from the medicine cabinet to help fall asleep but reports it “doesn’t help her stay asleep.”
Medications: None.
Allergies: No known drug allergies.
Review of Systems:
Constitutional: Lack of energy, no weight gain or loss.
HEENT: Reports no changes in hearing or vision, no runny nose, postnasal drip, or any URI symptoms.
Skin: No itching, dry skin, or rashes.
Cardiovascular: No chest pain, no history of cardiac anomalies, no murmurs.
Respiratory: No shortness of breath or difficulty breathing, no night sweats, no wheezing or history of RAD.
Gastrointestinal: No nausea, vomiting, or diarrhea/constipation. Occasional heartburn with certain foods.
Genitourinary: Unremarkable.
Musculoskeletal: No join pain or muscle pain.
Neurological: Frequent headaches, no double vision, no balance issues, or dizziness.
Hematologic: Denies bruising or easy bleeding.
OBJECTIVE
General: Well‐appearing with age‐appropriate clothing and good hygiene; initially shy but now more talkative.
Vital signs: T: 98.3°F; heart rate: 68; blood pressure: 110/68; RR: 18; height: 5 ft 4 inches; weight:
169 lbs; BMI: 29.
Eyes: PERRLA, EOM intact, dark circles under eyes.
ENT: Normal appearance of posterior oropharynx, nares patent, no postnasal drip, TMs gray pearly and visible ossicles.
Lymph: No lymphadenopathy.
Cardiovascular: No JVD, no carotid bruits, no murmurs, regular rate and rhythm, femoral pulses equal +2.
Lungs: Clear to auscultation bilaterally, no accessory muscle use, no crackles or wheezes.
Skin: Unremarkable.
Abdomen: Normal bowel sounds, abdomen soft and nondistended, no HSM.
Genitourinary: Not examined.
Musculoskeletal: Full range of motion in all 4 extremities.
Neurological: Alert and oriented × 3, CN 2–12 grossly intact.
CRITICAL THINKING
What are the most likely differential diagnoses in this case and why?
__Post‐traumatic stress disorder
__Unspecified trauma‐ and stressor‐related disorder __Child‐affected by parental relationship distress __Major depressive disorder __Generalized anxiety disorder__Hypothyroidism
Which diagnostic tests are required in this case and why?
__PHQ‐9
__Beck Depression Inventory
__The Non‐Suicidal Self‐Injury Assessment Tool (NSSI‐AT)
__Columbia–Suicide Severity Rating Scale (C‐SSRS Screener)__CBC with differential
__Thyroid panel
__CMP
What are the concerns at this point?
__Suicide risk assessment
__Self‐harm risk assessment__Safety of going home
__Headaches
__Sleep hygiene
__Hypothyroidism
What is the plan of treatment?
What is trauma‐informed care?
What are the plans for referral and follow‐up care?
What demographic characteristics might affect this case?
Does the patient’s psychosocial history impact how you might treat her?
If this patient were male (instead of female), how might that change management and treatment?
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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