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
Tamika, a 12‐year‐old girl, came to the community health clinic with her mother, who had requested an urgent appointment to discuss a note from Tamika’s physical education teacher with her nurse practitioner (NP). The note stated that Tamika was having difficulty keeping up with her class-mates because she became short of breath when participating in activities. Tamika denies any other episodes of shortness of breath but reports that she occasionally has to stop and rest when climbing stairs. She has no persistent cough, wheeze, or seasonal allergies. She reports that she has not yet had a period.
Diet history: Tamika seldom eats breakfast at home and occasionally will eat cereal from the school breakfast. For lunch she likes pizza or macaroni and cheese but does not eat if these items are not on the school menu. She arrives at her grandmother’s house around 3:30 p.m. and has a salty snack and a soda. She eats dinner with her father, either at home or at a local fast‐food restaurant.
Sleep history: Tamika’s mother notes that she snores loudly and sometimes awakens at night. She is currently not taking any medications.
Past medical history: Tamika was born after 36 weeks’ gestation to a 39‐year‐old mother. She weighed 4 lb 14 oz; and, in addition to being preterm, she was small for gestational age. Her mother smoked ½ ppd. Her neonatal history was unremarkable, and she was discharged at 1 week of age weighing 5 lb 2 oz. She was formula fed.
Her past medical history is otherwise unremarkable except for treatment on 2 occasions for right otitis media at ages 1 and 5 and for day surgery at age 18 months to repair a bilateral inguinal hernia. There were no complications. She has no history of respiratory illness, asthma, or allergy.
Family history: Positive for Type 2 diabetes in Tamika’s maternal grandmother. Her father is positive for cardiovascular disease and had a mild heart attack at age 48, has high blood pressure, and takes statins for elevated cholesterol. Her maternal grandfather died at age 42 from a heart attack and diabetes. Her paternal grandparents are reportedly alive and well and are living in Puerto Rico.
Social history: Tamika is in sixth grade. She is seldom absent and frequently makes the honor roll. She says she likes school but notes that she is shy and has few friends. She does not take part in any extracurricular activities and spends her after‐school time helping her grandmother cook or watching TV. She likes to read. She denies ever using tobacco products, drugs, or alcohol. She admits to feeling sad and lonely at times but denies ever wanting to injure herself. She likes her parents but says they don’t always understand her or have time to talk to her.
Tamika lives with both parents in a 2‐bedroom, third‐floor apartment near her school. Her father is employed as a laborer, and her mother works for a cleaning service 5 evenings a week. The family has a stable income. Tamika has 3 older siblings, ages 17, 19, and 21, living outside of the home. Her maternal grandmother lives nearby, and Tamika often goes to her home after school. Both parents were smokers previously but stopped 5 years ago. They moved to this area from Puerto Rico 20 years ago. Both speak fluent English.
OBJECTIVE
General: Tamika is a 12‐year‐old, Hispanic female who is neatly dressed and cooperative.
Vital signs: She is 5 feet tall and weighs 174 pounds. Her blood pressure is 116/70, pulse is 74, and respirations are 16 breaths/minute. Temperature is normal.
HEENT: PERRLA; EOMs intact. Oral pharynx is positive for 3+/4 tonsils, without lesions or exudate. No dental caries are noted.
Neck: Supple with full range of motion. No lymphadenopathy is present.
Respiratory: Her lungs are clear bilaterally with no wheezes, rales, or rhonchi.
Cardiac: Normal sinus rhythm with no murmur or irregular beats.
Chest: Breast buds are present bilaterally, with no tenderness or discharge.
Abdomen: Soft but protuberant with no masses or hepatosplenomegaly. Normal bowel sounds are heard in all 4 quadrants.
Neuromuscular: Back is straight with no curvature noted on forward bend. She has full range of motion in all extremities. Reflexes are normal.
Skin: Clear except for darkly pigmented areas on her neck.
CRITICAL THINKING
Which diagnostic or imaging studies should be considered to assist with or confirm the diagnosis?
___BMI
___Oral glucose tolerance test (OGGT)
___Insulin resistance
___Cholesterol screen
___Sleep study
___Psychosocial evaluation
What is the most likely differential diagnosis and why?
___Sleep apnea
___Obesity
___Insulin resistance
___Type 2 diabetes
___Exercise intolerance
___Psychosocial issues
Are any referrals needed at this time?
Can the school be of assistance?
What community resources are available to this family?
What type of nutrition support may aid this family?
NOTE: The author would like to acknowledge Elaine Gustafson, MSN, PNP, who co‐authored this case in the first edition of this book.
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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