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
Rami is a 72‐year‐old male presenting with 2 days of acute onset left great toe pain. He complains of pain with any movement or ambulation. He denies trauma or injuries. He woke up with the pain 2 days ago; it began very suddenly. He denies a prior history of foot or leg problems. He has never had symptoms like this before. Rami reports otherwise feeling well; he denies any systemic symptoms including fever or chills; however, he notes that his toe feels warm. He has been taking Tylenol 650 mg every 6 hours with minimal relief. He tried 2 ibuprofen yesterday that helped slightly. He avoids taking this, as it upsets his stomach.
Past medical history: Osteoarthritis, COPD, hypertension.
Family history: Rami’s mother and father have diabetes mellitus Type 2. His father has severe osteoarthritis.
Social history: Rami is a retired nurse. He lives alone; his wife died 3 years ago of pancreatic cancer. He has 4 children; they all live in New York where he is from, originally. Rami is a non-smoker and drinks 2 glasses of red wine nightly. He is fairly active, playing pickleball with the town league 1–2 × per week.
Medications: Tylenol 325 mg prn; Spiriva 1 inhalation daily; albuterol 50 mg qd; chlorthalidone 25 mg qd; amlodipine 10 mg qd
Allergies: Sulfa (hives)
OBJECTIVE
General: No apparent distress.
Vital signs: Temperature: 97.9°F (PO); BP: 158/72; pulse: 64 and regular. He is 5 ft 11 inches tall and 195 pounds.
General: Rami is pleasant and cooperative and in no distress.
Eyes: PERRL. No injection or icterus.
Cardiac: Regular rate and rhythm, no murmurs.
Lungs: Clear bilaterally.
Abdomen: Soft, nontender, nondistended. No palpable masses or hepatosplenomegaly.
MSK: Left great toe swollen with diffuse erythema, warmth, and tenderness to light touch over the metatarsal phalangeal (MTP) joint. Minimal flexion and extension of the great toe due to significant pain. Gait is antalgic due to pain.
Pulses: Bilateral dorsalis pedis and posterior tibial pulses 2+.
Skin: No rashes to the lower extremities, left great toe is diffusely erythematous.
CRITIAL THINKING
What is the most likely diagnosis and why?
___Sprain/strain
___Acute gouty arthritis
___Septic arthritis
___Osteoarthritis
___Rheumatoid arthritis
What are possible differential diagnoses?
Which diagnostic or imaging studies should be considered to assist with or confirm the diagnosis?
___X‐ray
___Complete blood count___BUN/Creatinine (renal function)
___Uric acid
___Joint aspiration
What is the plan of treatment?
Are there any modifiable risk factors or medications Rami is taking that could contribute to this diagnosis?
What are the plans for referral and follow‐up care?
What health education should be provided to Rami at this visit?
What if Rami had uncontrolled diabetes mellitus? How would this affect the treatment plan?
Rami recovers from his current symptoms but comes in again in 4 months with a similar problem. What should be done for him at this visit?
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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