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
Iris, a 48‐year‐old Asian female, presents with a report of insomnia and impaired concentration.
She has not slept through the night for approximately 6 weeks and finds that while she can fallasleep readily, she is too restless to stay asleep. At work (she works as an office manager), she is unable to concentrate and has found herself making simple mistakes. Iris is easily fatigued and states that she frequently feels warm and flushed, but she attributes this to “the time of life.” Her menstrual periods have become irregular. Her LNMP was 2 months ago. It lasted 10 days and was slightly heavier than usual. Iris states that she occasionally feels her heart “fluttering” when she feels anxious. She is surprised at this because she has always felt that she coped well with life and was generally happy. “Now, the littlest things seem to bother me and I feel my heart start to flutter. Oh, the change of life. I have dreaded it. Can you give me something for it?” Iris denies fever, chills, pain, weakness, or tremors.
Elimination: Iris has not noticed any changes in her weight or loose stools.
Past medical history: Iris had a hospitalization for a Cesarean section without complications 15 years ago. She also had a hemorrhoidectomy 7 years ago without complications.
Family medical history: Iris has a husband and 1 son who are alive and well. Her mother, age 67, has stage 1 Alzheimer’s disease and hypothyroidism. Her father has diabetes mellitus Type 2 and a history of colon cancer. Both are alive.
Social history: Iris lives with her husband and son and states that she is happily married and comfortable financially. She stopped using any form of birth control since her periods became irregular 6 months ago. She is a smoker, takes no medications, and has been generally healthy.
OBJECTIVE
The patient appears anxious but is pleasant and cooperative. Her weight is 136 lbs; she comments that this is 10 lbs less than the last time she checked her weight 3 months ago. Oral temperature is 100° F. BP is 148/94. HR is 96 and regular. Respirations are 12 and regular.
HEENT: Hair is shiny and soft. No exophthalmos is observed. There is no lid lag or retraction. Sclerae are clear and conjunctivae are without injection. PERRLA and EOMs are intact. CNs II–XII are grossly intact. There is no cervical lymphadenopathy. Trachea is midline. The thyroid is mildly palpable with a bruit. There are no nodules.
Skin: The patient’s skin is warm and moist.
Cardiac: HR: 96; RRR: S1/S2; no murmurs, clicks, gallops, or rubs. EKG reveals NSR without abnormalities.
Pulmonary: Lungs are clear bilaterally.
Abdomen: Soft without tenderness or distention. No organomegaly, no bruits. Bowel sounds are active throughout.
Neurologic: There are no tremors. Sensation and proprioception are grossly intact. DTRS are +3 in upper extremities and lower extremities. Romberg is negative. RAMs are negative. Gait is steady.
Musculoskeletal: FROM and strength of 5/5 in all extremities.
CRITICAL THINKING
What is the most likely differential diagnosis in this case and why?
__Hyperthyroidism
__Hypothyroidism
__Menopause
__Pregnancy
__Anxiety/depression
__Infection
Which diagnostic tests are required in this case and why?
__TSH
__CBC
__CMP
__HCG
__CXR
__Radionucleotide uptake scan with iodine (RAI)
__Ultrasound of thyroid
__FSH
__T3
__T4
__Free T4
__Thyrotropin receptor antibody (TRAb)
__Antithydroperoxidase antibody (TPO)
__ANA
__LDL
__HDL
What is the plan of treatment?
What is a likely diagnosis if this patient returns with severe tachycardia, confusion, vomiting, diarrhea, high fever, and dehydration?
What if this patient’s lab results return and the TSH is low with normal results for free T4 and T3?
Would the plan be any different if Iris were unemployed?
Are there any standardized guidelines that should be used to assess and 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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