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
Shanae is a 32‐year‐old female who presents with lower abdominal pain and fever. Fevers at home range between 99.4°F to a maximum of 101.7°F. She describes the lower abdominal pain as a constant dull ache, nonradiating, with a pain scale ranging from 5/10 to 8/10. The pain is worse with sexual intercourse. Shanae is taking acetaminophen 650 mg every 4 hours with minimal relief. She reports general malaise and that for the past 2 weeks she has been having heavy, purulent vaginal discharge. Three weeks ago, Shanae went to an urgent care clinic for dysuria. At that time, there was concern about a sexual transmitted infection and Shanae was treated for gonorrhea and chlamydia.
Past medical history: Polycystic ovarian syndrome, gonorrhea, herpes simplex virus type‐2
Gynecologic history: Two abnormal Pap smears requiring repeat testing and cone biopsy with negative results.
Menstrual history: Menstrual cycles irregular between 28 and 35 days, lasting 5–7 days of heavy bleeding. LMP 1 week ago.
Family history: Mother with history of cervical cancer and died at the age of 38, father with alcohol and substance abuse, no other history known.
Sexual history: Shanae reports having a poor sexual relationship with her husband, from whom she is separated. She left her husband after finding out he was having extramarital relationships and has engaged in several sexual relationships of her own. She now reports current sexual activity as intercourse with only one partner. She and her partner use condoms on most occasions; however, there has been a few occasions when they did not use condoms. She is currently satisfied with her sexual partner with whom she engages in vaginal, oral, and rectal sexual intercourse.
Substance use: Shanae denies use of tobacco. She reports occasional alcohol use of 1–2 drinks per month. She reports daily or near daily smoking of marijuana and has used cocaine in the distant past, none recently.
Safety: Shanae reports feeling safe at home and in her current relationship. She says that the rela-tionship with her husband was beginning to feel unsafe due to constant fighting. Since the sepa-ration, she has had no safety concerns and in the process of finalizing a divorce.
Medications: Ibuprofen 600 mg as needed, OCP (Yasmin) once daily.
Allergies: NKDA,
OBJECTIVE
General: Shanae is pleasant but appears in distress, guarding her abdomen.
Vital signs: Temperature: 100.4°F; BP: 100/52; HR: 110; respirations: 24.
Skin: Hot to touch, no lesions, no rashes.
Abdomen: Abdomen + bowel sounds, soft, nondistended. Positive suprapubic pain elicited upon palpation. No rebound tenderness, Turner sign, or Cullen sign.
Pelvic: Cervix midline, friable cervical OS; yellow discharge noted from the OS. Positive cervical motion tenderness. No lymphadenopathy and no adnexal masses.
Rectal: No lesions, no masses; normal sphincter tone.
CRITICAL THINKING
What is the most likely differential diagnosis in this case?
___Ectopic pregnancy
___Pyelonephritis
___Pelvic inflammatory disease
Which diagnostic tests are required in this case and why?
___CBC
___Nucleic acid amplification tests (NAAT)
___Beta hCG
___HIV
___Wet mount
___Treponema pallidum
___Transvaginal ultrasound
What is the plan of treatment?
What are the plans for follow‐up care?
What health education should be provided to this patient?
Are there any standardized guidelines that should be used to treat this case? If so, what are they?
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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