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
Rachel is a 17‐year‐old Caucasian female who presents with complaints of decreased appetite, fatigue, nausea, and intermittent abdominal pain for the past 2–3 weeks. She describes the abdom-inal pain as sharp and focused in the right epigastric area. She also reports some new‐onset pain in her right shoulder but attributes this to carrying around her baby more than usual. She denies vomiting, diarrhea, or constipation. Her typical diet consists of pizza, hot dogs, and salads. Rachel denies any association of her symptoms with food or hunger. Her last normal menstrual period was 3 weeks ago, and she has had 2 negative pregnancy tests at home.
Past medical history: She delivered her son 6 months ago vaginally without complications. Her only other medical history includes a kidney infection 4 months ago.
Social history: She smokes 7 cigarettes a day but admits, “I really don’t need them. I am bored.” Rachel lives with her boyfriend (the father of her child) and his parents. She moved in, far away from her home, only recently. Her parents made her leave their house when she told them she was pregnant, and they have no contact with her. She states that she feels safe at home and is enjoying her baby. Her boyfriend helps with the baby but often goes out at night with his friends and leaves her at home with the baby. She feels a little isolated because everyone works during the day and she has no access to transportation. She is dependent on her in‐laws if she needs to go anywhere by car, and they do not often support her need to go anywhere. Otherwise, she walks. She walked here today for her appointment.
Medication: She is not allergic to any medication and only takes birth control pills.
OBJECTIVE
Vital signs: Rachel is afebrile. BP is 120/80. Pulse is 68 and regular.
Eyes: PERRLA. EOMs are intact. Optic disks are sharp.
Cardiac: Cardiac exam reveals regular rate and rhythm.
Respiratory: Respirations are 12, steady, and unlabored. Lungs are clear.
Abdomen: Soft with mild tenderness to palpation (TTP) in the RUQ with a positive Murphy’s sign. There is no CVA tenderness.
Genitourinary: A urine dipstick reveals positive protein. A urine HCG is negative.
Rachel is diagnosed at this first visit with possible cholecystitis and is given Antivert 12.5 mg for her nausea.
Blood is drawn and sent to the lab. Her urine is sent for analysis, and she is told to return in 1 week.
Rachel returns 1 week later. Her bloodwork reveals a blood glucose of 45 mg/dL. Her other blood-work is within normal limits. Her urinalysis returns with few bacteria and no protein. Rachel reports that the abdominal pain has worsened and she now has headaches. She denies a history of migraines or frequent headaches. Her nausea is still present but decreased.
Her exam remains unchanged.
CRITICAL THINKING
What is the most likely differential diagnosis in this case and why?
__Cholelithiasis
__Gastroenteritis
__Diverticulitis
__Insulin tumor
__Gastric tumor
__Cholecystitis
Which diagnostic tests are required in this case and why?
__Abdominal ultrasound
__Abdominal CT scan
__Head CT scan
__KUB X‐ray__CBC
__Metabolic panel
__LFTs
__Insulin level
__C‐peptide__OGGT
__Gastrin level
What is the plan of treatment?
Are any referrals needed?
Does the patient’s home situation influence the plan?
Are there any standardized guidelines that should be used to 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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