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
Martha is a 24‐year‐old female who reports vaginal itching for 3 days. She says that she can barely focus on other things because of the itching. She also reports a copious, white vaginal discharge. Her last Pap smear was at age 22 and was negative. She has not received the HPV vaccine series. Martha denies previous episodes and states that she is otherwise healthy. She denies fever, chills, nausea, vomiting, or diarrhea. She is sexually active with both male and female partners since the age of 15. She states that recently she has been exclusively with females but has had 2 sexual partners in the past year. She states that she still feels somewhat confused about her sexual preferences. She admits to dyspareunia and burning with urination. She denies use of vaginal sprays, douches, or powders or the use of new soaps, detergent, or clothing. Her last menstrual period (LMP) was 3 weeks ago.
Past medical history: Recurrent strep pharyngitis—last episode 3 weeks ago.
Family history: Remarkable for diabetes mellitus and COPD.
Social history: Martha is a college graduate and still lives with her widowed mother. She feels safe and has a good relationship with her mother but has not disclosed her sexual preferences to her mother. Martha does worry about their financial status as she and her mother have low‐paying jobs and do not have other financial support. They are currently renting their apartment from a friend. Martha does not smoke and denies substance use.
Medications: None currently. She completed a 10‐day course of amoxicillin 1 week ago for strep pharyngitis.
Allergies: Seasonal in spring.
OBJECTIVE
Vital signs: Martha is afebrile. Her BP is 110/70. Pulse is 64 and regular. Respirations are 12 and unlabored. She is 5 ft 3 inches tall and weighs 120 lbs.
General: Martha is pleasant and cooperative but seems anxious about the visit.
Throat: No swelling or exudates.
Cardiac: Regular rate and rhythm.
Respiratory: Lungs are clear bilaterally.
Abdomen: Soft, nontender, nondistended, and without organomegaly.
Pelvic exam: Inguinal lymph nodes are without swelling or tenderness; vaginal mucosa is moist, pink, and mildly swollen. There is no foul odor; but there is a white, cottage cheese–like discharge at the introitus. The cervix is pink and without friability. There is no cervical motion tenderness (CMT). The pH of the vaginal discharge is within normal range (3.8–4.2).
CRITICAL THINKING
Which diagnostic or imaging studies should be considered to assist with or confirm the diagnosis?
___Pap smear
___Cultures for gonorrhea and chlamydia
___Urine testing for gonorrhea and chlamydia
___Wet mount, including KOH and whiff test
___Urinalysis
If a wet mount were performed, what findings would be expected for the following diagnoses?
• Bacterial vaginosis
• Candidiasis
• Trichomonas
What is the most likely differential diagnosis and why?
___Bacterial vaginosis
___Candidiasis
___Trichomonas
___Gonorrhea
___Chlamydia
___Herpes simplex
___Urinary tract infection
What is the plan of treatment?
What education should be provided to Martha at this visit?
Are any referrals needed?
Is the family history of diabetes relevant to this case?
How can the clinician support the patient regarding her confusion with her sexual preferences?
NOTE: The author would like to thank Leslie Neal‐Boylan, PhD, APRN, CRRN, FAAN, FARN for her contribution 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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