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
Rosa is a 74‐year‐old woman who presents with a complaint of itching and soreness in her left side and upper back. She tells you that she has been gardening and that she thinks she may have a spider or bug bite, but she cannot see this area. She felt an “irritation” 2–3 days ago with inter-mittent itching. She took some oral OTC Benadryl© without benefit. She now complains of inter-mittent “shooting pain” and “tingling” sensations around the area of the left shoulder blade. She has been wearing a camisole instead of a bra for comfort. She denies itching in any other location on the body and has no other dermatological complaints. She denies recent trauma to the chest or back. She denies use of new shampoos, lotions, laundry products, clothing, perfumes, or topical agents.
Past medical history: Positive for hypertension (HTN); osteoarthritis (OA, primarily of the knees and fingers); gout; osteoporosis, and polymyalgia rheumatica (PMR).
Medications: Zestoretic, 1 tablet by mouth once per day; alendronate, 70 mg, by mouth, once per week; allopurinol, by mouth, 200 mg po once per day; Prilosec, 20 mg by mouth once per day; and prednisone, 7.5 mg by mouth, once per day. She has been taking these medicines for over 1 year (with varying prednisone dose adjustments).
Allergies: She denies any environmental, contact, or medication allergies.
OBJECTIVE
Head: Abundant, slightly dry hair in normal distribution with no alopecia or breaking. Head is normocephalic and atraumatic.
Lymph nodes: No palpable lymphadenopathy in head, neck, thorax, or axilla.
Skin: Pale with multiple scattered, small, bright‐red, pinpoint papules over the chest and back, as well as several irregularly shaped, flat, light‐brown macules. She has no visible rash, discoloration,
or lesion in the affected area, and no obvious insect bite or entry wound. Her skin is very dry in all areas.
Thorax: Exquisite tenderness on palpation in the left subscapular area, extending to the anterior axillary line, lateral to the left breast.
Her remaining physical examination is within normal limits.
CRITICAL THINKING
What is the most likely differential diagnosis and why?
__Bug bite
__Contact dermatitis
__Eczema
__Herpes zoster
__Infestation (lice or scabies)
__Medication‐related adverse effects__Polymyalgia rheumatica (exacerbation)
__Rib fracture
__Seborrheic dermatitis
__Systemic disease
__Xerosis (dry skin)
Which diagnostic or imaging studies should be considered to assist with or confirm the diagnosis?
__Erythrocyte sedimentation rate (ESR or “sed rate”)
__Immunoglobin E titer
__Immunoglobin G titer for varicella zoster
__Metabolic (chemical) profile including LFTs, BUN/creatinine, electrolytes, and TSH
__Polymerase chain reaction (PCR) testing
__Skin biopsy
__Skin scraping for microscopy
What is the management plan?
Are any referrals appropriate at this time?
Which of the clinical findings are consistent with normal aging changes?
What are the most common causes of pruritus (itching) in older adults? What are the risks and benefits of antihistamine therapy for pruritus, such as diphenhydramine (Benadryl©)?
If new lesions continue to appear after 1 week, what additional considerations should be addressed?
Which specific vaccines’ dates of administration should be included in immunization documen-tation for older adults?
How can excess disability be prevented?
How can comfort (physical, psychosocial, and spiritual) be enhanced, beginning immediately?
How can suffering be reduced?
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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