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
Andrew is a 42‐year‐old African American male who presents with BP 168/92 and morning head-aches. Andrew reports headaches upon arising approximately 2 times per week. This morning prompted his coming to the office for evaluation, as he felt some lightheadedness and chest tight-ness that resolved following his shower. He has never been told that his blood pressure was high, but he has not been seen in the office for 6 years. His last visit was for bronchitis and treatment with antibiotics.
Past medical/surgical history: He has no surgical history.
Family history: His father is deceased at age 65 from an acute MI; one brother died at age 50 with acute MI, following abdominal aortic aneurysm surgery. He has 4 other siblings in good health.
Social history: Andrew has been dealing with several life issues, including the death of a child and a reduction in his work hours at a local manufacturing plant. He smokes 2 packs of cigarettes per day, leads a sedentary life outside of work, and is overweight at 6 ft 2 inches and 255 pounds (BMI = 33). He reports generally good health. His smoking history is 44 years. He is married and has 3 remaining children, ages 12, 15, and 17. His oldest son was killed in a car accident 2 months ago. He drinks moderately, generally 2–3 beers 4–5 times per week. He reports drinking more heavily on the weekends. He and his wife are active in their church. He is a high school graduate and makes approximately $50,000 annually. His wife has a full‐time position that supplements the family income to approximately $90,000. For the past 3 months, his business has experienced a downturn and there have been mandatory furlough days, which have required their family spending to be seriously curtailed, although they are able to meet their financial obligations at this time.
Medications: Andrew takes a daily aspirin and a multivitamin, but he is on no prescription med-ications at this time.
Allergies: No known allergies. He reports being lactose intolerant.
OBJECTIVE
General: Patient appears older than his stated age; frowning.
Vital signs: BP on arrival is 188/110. After 20 minutes, repeat BP is 180/90. P: 94; R: 20; T: 98.2°F.
HEENT: Cranial nerves intact. EENT exam negative.
Neck: No lymphadenopathy.
Skin: Skin warm and dry.
Respiratory: Lung sounds vesicular over peripheral fields; harsh, bronchial breath sounds in upper lobes bilaterally; moist cough audible; no adventitious breath sounds.
Cardiovascular: No jugular venous distention at 30 degree elevation. Heart sounds strong 3/4; grade 2/6 systolic murmur at left sternal border, 5th ICS. Abdominal and peripheral vascular assessments negative; pedal and post tibial pulses 2+/4+.
Abdomen: Tender over right upper quadrant. Tympany predominates. Liver border WNL, spleen and kidneys nonpalpable.
Neuromuscular: Romberg’s sign negative; gait relaxed and symmetrical; no pronator drift. Full ROM all extremities.
CRITICAL THINKING
Which diagnostic studies should be considered to assist with or confirm the diagnosis?
___Electrocardiogram
___Troponin
___CBC
___Comprehensive metabolic panel
___Serum cholesterol panel
What is the most likely differential diagnosis and why?
___Obstructive sleep apnea
___Hypertension
___Dyslipidemia
___Cardiovascular disease
___Diabetes mellitus
___COPD
What is the plan of treatment?
What is the plan for referrals and follow‐up care?
What if this patient were female?
What if this patient were also diabetic?
Are there any standardized guidelines that should be used to assess or treat this case?
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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