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
James is a 5‐year‐old male who presents to his pediatrician after being seen in the emergency room 2 days prior for hives and trouble breathing after eating a peanut butter and jelly sandwich. His mother reports that James has had peanut butter before and would occasionally cough but has never had any skin changes that she can remember and certainly never had trouble breathing. She wonders whether he was choking on the peanut butter instead of having an allergic reaction but concedes that he turned red and was gasping for breath. He was also found to have hives all over his back and trunk. “No one in our family has a peanut allergy and it’s basically all that his older brother eats. It would be a real problem if we couldn’t have it in the house.” The provider explains to the mother that James recovered from his episode after receiving a dose of epinephrine, which would not have helped if he was choking, and hives are not caused by simply coughing. The pro-vider asks if James has had any peanuts since the incident and mother says “no.” James has also not had any further episodes of hives or respiratory distress since being discharged from the hospital. His mother grudgingly agrees that it probably wasn’t choking, but asks “Are you sure that this was an allergy? Could we get him tested or something? What do we in the meantime?” She holds up the EpiPen that she was given at the hospital: “I don’t want to carry this around all of the time and James isn’t old enough to know how to use it.”
Birth history: James was born via normal, spontaneous vaginal delivery at 42 weeks. He weighed 10 lbs, 1 oz. He did not spend any time in the neonatal intensive care unit (NICU) and was discharged to home with his mother at 2 days of life.
Social history: James lives with his mother, father, 8‐year‐old brother (Kevin), and 1‐year‐old sister (Kyla). James attends full‐day kindergarten at a local public school. The family has 2 cats and a fish.
Diet: James is considered “overweight” by BMI, but is an active child with a lot of muscle. He plays soccer in the fall and baseball in the spring and summer. He has a total of 1 hour of recess per day at school. He eats a variety of foods, including grains, fruits, andvegetables, and his main protein sources are peanut butter and chicken. He drinks 8 oz of juice per day and about 12 oz of milk per day.
Elimination: James has no history of constipation and no history of urinary tract infection (UTI).
Sleep: James has an inconsistent bedtime routine, but generally goes to bed around 8 p.m. on school nights and wakes up at approximately 6 a.m. On the weekends, he is often up until 10 p.m. but still wakes up around 6 a.m.
Family medical history: James’s father has lactose intolerance and James’s mother has a history
of eczema. Maternal grandmother: history of breast cancer (still living); paternal grandmother:
hypertension (on medications); maternal grandfather: prostate cancer (still living) and Type 2
diabetes; paternal grandfather: deceased from heart attack at age 62; maternal aunt: history of
celiac disease; paternal aunt: history of hypothyroid; paternal uncle: history of depression.
Medications: James does not take any medications.
Allergies: James has no known drug allergies but may have a peanut allergy.
OBJECTIVE
Vital signs: Heart rate is 110; respiratory rate is 13; oxygen saturation is 100% on room air; blood pressure is 98/62. Denies any pain.
General: Well‐appearing 5‐year‐old child, appears masculine in dress and manner. He is in no distress.
HEENT: Normocephalic head with no appreciable lumps or bumps. Eyes demonstrate ability to fix and focus, pupils are equal, round, and reactive to light. Ears are set proportionately to head. Tympanic membranes are visible with no evidence of infection (no pus/fluid/erythema). Trachea is midline. Thyroid is appropriate in size. Mucous membranes are moist. Dentition demonstrates 1 loose tooth and 1 missing tooth. All primary teeth at this time.
Cardiovascular: Regular heart rate and rhythm. No rubs, murmurs, or gallops heard.
Respiratory: Lungs clear to auscultation in all fields. No wheezes, rhonchi, or rales.
Abdomen: Soft, nontender, nondistended. Normoactive bowel sounds are present in all four quadrants.
Gastrointestinal/Genitourinary: Deferred.
Neurological: Grossly intact. Demonstrates grossly normal hearing, vision, balance. No abnormal gait observed.
Musculoskeletal: All 4 extremities move equally with appropriate strength and range of motion.
Skin: Color is appropriate for race; no pallor. No rashes or hives noted. Patch of mild eczema on left lower extremity. Temperature and texture otherwise within normal limits.
CRITICAL THINKING
What are the top three differential diagnoses? What testing will confirm the diagnosis?
How should the provider educate the mother about the seriousness of anaphylaxis and the risk of it occurring again?
How can the provider help the school manage a child with food allergies?
If this family does not have insurance, what is the expected out‐of‐pocket expense for an EpiPen? Likely more than one will be needed, so how can a family navigate this barrier?
What is the essential information that all caregivers (not just parents) need to know when caring for James?
What advice should the mother be given regarding introduction of peanut‐based products to the youngest child now that food allergies are known to be in the family?
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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