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
Six‐year‐old Daniel presents to the office with his mother, Donna, with complaints of frequent night-mares. Donna states that Daniel will be asleep and will suddenly sit upright with his eyes open and start to scream loudly. She says that Daniel looks terrified and that he sweats and breathes fast during these episodes. Donna says that while Daniel is screaming, she is unable to wake, console, or comfort him. The screaming episodes typically last about 5 minutes each and happen 3–4 times weekly. Donna states that after the screaming stops, Daniel returns to sleep and does not remember the screaming episodes when he awakens in the morning. Daniel does not have any problems falling asleep. He sleeps approximately 10 hours each night but does not have a set bedtime or a regular bedtime routine. He sleeps in his own bed and shares a room with his younger brother.
Diet: Balanced diet with sufficient sources of dairy, protein, fruits, and vegetables.
Elimination: Daniel is voiding well with no complaints of dysuria. He has 1 bowel movement daily and denies constipation or diarrhea.
Past medical history: Born via vaginal birth at 40 weeks’ gestation. The mother’s pregnancy was without problems. She had no infections, falls, or known exposures to environmental hazards. She did not drink alcohol, take prescription medication (other than prenatal vitamins), use tobacco products, or use illicit drugs. There were no problems for Daniel during his neonatal period. Since birth, he has had no injuries or illnesses requiring visits to the emergency department. He has no chronic illnesses.
Family history: Daniel’s mother (27 years old) and father (26 years old) are both healthy and have no history of chronic medical conditions. His 3‐year‐old sibling also has no history of chronic medical conditions. His maternal grandmother (54 years old) has a history of asthma. His maternal grandfather (55 years old) has a history of high cholesterol. Daniel’s paternal grandmother (52 years old) has a history of hypertension. His paternal grandfather (52 years old) has a history of hyper-tension and had a stroke at age 47 years.
Social history: Daniel lives at home with his mother, paternal grandmother, paternal uncle, and his younger brother (3 years old). His mother works as a restaurant waitress. Daniel’s father is incarcerated. The family has no pets. There are no smokers in the home.
Medications: Daniel is not currently taking any over‐the‐counter, prescription, or herbal medica-tions. He has no known allergies to medication, food, or the environment. He is up to date for required immunizations.
OBJECTIVE
General: Alert, cooperative, and active; appears well hydrated and well nourished.
Vital signs: Weight in the office was 28 kg. Temperature was 36.9°C (temporal).
HEENT: Normocephalic. Red reflexes are present bilaterally; and pupils are equal, round, and reactive to light. There is no ocular discharge noted; external ear reveals that the pinnae are normal and that there is no tenderness to touch on the external ear. On otoscopic examination, the tympanic membranes are gray bilaterally, in normal position, with positive light reflexes. Bony landmarks are visible, and there is no fluid noted behind the tympanic membranes. Both nostrils are patent. There is no nasal discharge and no nasal flaring. Daniel’s mucous membranes were noted to be moist when examining his oropharynx. There is no evidence of visible caries or other lesions in the oral cavity.
Neck: Supple and able to move in all directions without resistance. There was no cervical lymph-adenopathy present.
Skin: Clear of lesions; no cyanosis of his skin, lips, or nails; no diaphoresis noted; and there is elastic recoil.
Respiratory: Respiratory rate is 20 breaths per minute, and the lungs are clear to auscultation in all lobes. There is good air entry, and no retractions or grunting are noted on examination. No deformities of the thoracic cage are noted.
Cardiac: Heart rate is 102 beats per minute with a regular rhythm. There is no murmur noted upon auscultation.
Abdomen: Normoactive bowel sounds are present throughout. Soft and nontender. No evidence of hepatosplenomegaly.
Genitourinary: Normal circumcised male genitalia without erythema or lesions; testes are descended bilaterally.
Neuromusculoskeletal: Good tone and full range of motion in all extremities. Extremities are warm and well perfused. Capillary refill is less than 2 seconds. Spine is straight.
CRITICAL THINKING
Which diagnostic or imaging studies should be considered to assist with or confirm the diagnosis?
___EEG (electroencephalogram)
___Polysomnography
___MRI (magnetic resonance imaging)
___CT (computed tomography) scan
___Skull radiograph
What is the most likely differential diagnosis and why?
___Nightmares
___Nocturnal seizures
___Night terrors
___Sleepwalking (somnambulism)
What is the plan for treatment, referral, and follow‐up care?
Does this patient’s psychosocial history affect how you might treat this case?
What if the patient lived in a rural setting?
Are there any demographic characteristics that might affect this case?
NOTE: The author would like to acknowledge the contribution of Allison Grady, MSN, RN to this case in the first edition of this book.
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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