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
Chan Ming, a 26‐year‐old woman, presents with her partner requesting assistance to “get off pills.” She reports a gradual progression from “partying” with alcohol and marijuana, starting at age 15, to using opioids, leading to a variety of legal and social problems. She has tried to quit on her own but experiences withdrawal symptoms (nausea, diarrhea, chills, runny nose, achiness).
Past medical history: Attention‐deficit hyperactivity disorder (ADHD) (diagnosed at age 10), anxiety.
Past surgical history: Right knee anterior cruciate ligament repair (at age 24).
Family history: Father, age 48, is “alcoholic”; paternal uncle, age 43, has depression and has attempted suicide.
Social history: Chan Ming works at a local gym but recently lost her job due to repeated tardiness and absences. She was going to community college until about 6 months ago but stopped due to poor grades and financial restrictions. She used to smoke about 1 pack per day of cigarettes but transitioned to vaping nicotine pods about 3 months ago. She reports drinking alcohol (6–8 drinks) multiple days per week (Thursday–Sunday). She also reports near‐daily cannabis use (smokes or vapes 1–2 “bowls” daily at night). For the past 21/2 years, she reports she has been taking “pills” (hydrocodone, oxycodone) daily. Initially, she was given prescriptions for these medicines due to knee pain and post‐surgical pain but during a later visit, she reports that she is now purchasing them illicitly. She also reports that within the past month, she began snorting “heroin” (likely fentanyl, based on regional prevalence) because the price of pills was so high, and she was having severe withdrawal symptoms when she tried to cut back and stop on her own. She reports that when she finally admitted how often she was using these drugs and how she was unable to stop on her own, her partner became scared and insisted that they needed help.
Medications: Methylphenidate extended‐release, 60 mg daily.
Allergies: NKDA.
OBJECTIVE
General: Chan Ming appears restless, irritable, and mildly diaphoretic.
Vital signs: Heart rate is 105 beats per minute. Blood pressure is 136/88 mmHG. Respiratory rate is nonlabored and 20 breaths per minute. Temperature is 98.7° F.
Skin: Mild diaphoresis (clammy skin) is present. There are no rashes, bruises, or areas of redness.
HEENT: Skull is normocephalic. Pupils are 3 mm, round, and reactive. Conjunctivae are moist. There is no icterus. There is mild rhinorrhea in both nares. Otherwise, the remaining HEENT exam is unremarkable.
Neck: There is no jugular venous distention, thyromegaly, or any palpable lymph nodes.
Cardiac: Mild tachycardia (rate 105) is present. Rhythm is regular. There is no murmur, rub, or gallop.
Respiratory: Lungs are clear to auscultation.
Abdomen: Abdomen is nontender. There is no hepatosplenomegaly.
Neurologic: Cranial nerves 2–12 are intact. Romberg sign is negative. Gait is smooth and coordinated.
CRITICAL THINKING
What are the top three differential diagnoses in this case and why?
Which diagnostic tests are required in this case and why?
What are the concerns at this point?
What are the options for the medicinal management of acute opioid withdrawal?
What are the three FDA‐approved medicines for maintenance therapy for opioid use disorder (OUD) and which may be prescribed in primary care?
What are health promotion/health prevention/harm reduction topics that should be addressed with this patient?
What is the plan of treatment?
What are the plans for referral and follow‐up care?
What health education should be provided to this patient?
What demographic characteristics might affect this case?
Does the patient’s psychosocial history impact how you might treat him?
What if the patient lived in a rural (or urban) setting?
Are there any standardized guidelines that should be used to treat this case? If so, what are they?
What other professionals might you collaborate with to best provide comprehensive care for substance use disorder?
If you discovered that the patient was using substances intravenously, what other concerns/ testing/treatment would you want to consider?
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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