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
Susan is a 42‐year‐old female who presents with a report of burning pain on urination for the past 2 days. She has been urinating frequently and finds that she has to run to make it to the bathroom in time to void in the toilet. She vaguely remembers similar symptoms once in college but doesn’t remember what she was diagnosed with or how she was treated for it. She denies flank pain but does have some mild suprapubic pain. She admits to mild dyspareunia in the past few days. Susan is otherwise well but admits to being thirsty more frequently than usual. Her menses are regular, and her LNMP was 10 days ago. She denies vaginal itching, foul odor, or discharge. Her 2 children were born via vaginal deliveries without complications. She does not recall when she last had a pelvic exam or Pap smear and recalls a remote history of an abnormal Pap smear. She thinks she had a colposcopy at that time and after 1 year, she was told to resume a normal Pap smear schedule.
Social history: Susan is a recently divorced mother of 2 young children. Her ex‐husband was “fooling around” while they were married, so Susan is worried that she might have a sexually transmitted infection. Since the divorce, Susan has had 1 new male sexual partner. They began their sexual relationship about 1 week ago and did not use condoms because Susan was on birth control pills and “I trust this new man.” She works full‐time as a preschool teacher and takes care of her children, ages 12 and 15, by herself and without financial support from her ex‐husband. Susan does not smoke but has an occasional (1 per month) glass of wine. She admits to having used marijuana in college.
Family medical history: Notable for diabetes Type 2 (mother) and hypertension (father).
Medications: Birth control pills.
OBJECTIVE
General: The patient is in no acute distress and is pleasant and cooperative.
Vital signs: Oral temperature is 98°F. BP is 116/74. HR is 64 and regular.
Respiratory: Respirations are 14 and regular. Lungs are clear bilaterally.
Back: There is no CVAT.
Cardiac: RRR S1/S2; without murmurs, clicks, gallops, or rubs.
Abdomen: Soft, nontender, nondistended, without organomegaly. Bowel sounds are active in all 4 quadrants.
Reproductive: Pelvic exam reveals no inguinal lymphadenopathy; moist pink vaginal mucosa, negative chandelier sign, and pink anterior cervix without friability. Cervical discharge is thin, white, and odorless. Samples are obtained for culture. This patient could also have provided a urine sample to test for gonorrhea and chlamydia. However, given her history with a new partner and an ex‐husband who had other partners, as well as the length of time since her last pelvic exam, it is reasonable to do a pelvic exam at this time. A Pap smear is also performed because Susan cannot recall when she last had one and there is none noted in the electronic record. The test will include HPV testing. The bimanual exam reveals no masses or tenderness.
CRITICAL THINKING
What is the most likely differential diagnosis and why?
__Pregnancy
__Acute cystitis
__Interstitial cystitis
__Diabetes mellitus
__Pyelonephritis
__Pelvic inflammatory disease
__Urinary tract infection (UTI)
Which diagnostic studies should be considered to assist with or confirm the diagnosis?
__Urine dipstick
__Urinalysis
__Urine culture and sensitivity
__CBC
__CMP
__TSH
__Renal ultrasound
__Abdominal and pelvic ultrasound
What is the plan of treatment?
What is the plan for referrals and follow‐up?
Would the diagnosis change if the patient had fever and flank pain?
Would the most likely diagnosis change if the patient were male?
What is an important symptom to consider in an older adult?
What if Susan were pregnant?
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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