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
Four‐year‐old Jennifer presents to the office with a complaint of abdominal pain for 2 days. She is accompanied by her mother, Anat. Anat states that Jennifer’s pain is intermittent and is mainly on the left side of her abdomen. She states that the pain is sometimes worse after eating and that the pain is sometimes relieved by passing gas. Jennifer is unable to describe the quality of the pain, but Anat states that Jennifer will sometimes “double over” in pain. Jennifer has had no vomiting or diarrhea. She has had no cough or runny nose.
Diet: Jennifer’s nutrition history reveals that she eats bananas and rice almost daily. She drinks 4–5 cups of whole milk daily.
Elimination: She is voiding well with no complaints of dysuria. Jennifer has 2–3 bowel movements per week. Anat is unsure of the amount or consistency, since she rarely accompanies Jennifer into the bathroom.
Sleep: Jennifer sleeps approximately 10 hours at night. She has no problems falling asleep or staying asleep. Her sleep has not been interrupted by her abdominal pain.
Past medical history: Jennifer was born via cesarean section at 37 weeks’ gestation. Since being discharged at 4 days of age, she has had no emergency department visits or hospitalizations. Jennifer had bronchiolitis at 6 months of age but has had no injuries or illnesses since that time. Jennifer passed her developmental screening at her last well‐child visit. She currently attends pre-kindergarten and is doing well, according to Anat. She has no chronic illnesses and is not currently taking any medications.
Social history: Jennifer lives at home with both parents and a 2‐year‐old sibling. Her mother works as a nurse, and her father is a firefighter. The family has a pet chihuahua. There are no smokers in the home.
Family medical history: Jennifer’s mother (29 years old) and father (29 years old) are healthy and have no history of chronic medical conditions. Her 2‐year‐old sibling is healthy as well. Her maternal grandmother (52 years old) has a history of Crohn’s disease. Her maternal grandfather (54 years old) has a history of asthma. Jennifer’s paternal grandfather passed away at 47 years of
age from stomach cancer. Her paternal grandmother (53 years old) has a history of obesity and Type 2 diabetes.
Medications: Jennifer is currently taking no over‐the‐counter, prescription, or herbal medications. She has no known allergies to medications, food, or the environment. She is up to date on required immunizations.
OBJECTIVE
Jennifer’s vital signs are taken, and her weight in the office today is 27 kg. Her temperature is 37°C (temporal). She is alert, cooperative, and interactive. She appears well hydrated and well nourished.
Skin: Her skin is clear of lesions. There is no cyanosis of her skin, lips, or nails. There is no dia-phoresis noted. Jennifer has good skin turgor on examination.
HEENT: Jennifer’s head is normocephalic. Red reflexes are present bilaterally; and pupils are equal, round, and reactive to light. There is no ocular discharge noted. Julia’s external ear reveals that the pinnae are normal and that there is no tenderness to touch on the external ear. On otoscopic examination, the tympanic membranes are gray bilaterally and in normal position with positive light reflexes. Bony landmarks are visible, and there is no fluid noted behind the tympanic mem-branes. Both nostrils are patent. There is scant nasal discharge, and there is no nasal flaring. Jennifer’s mucous membranes are noted to be moist when examining her oropharynx. She has 20 teeth present without evidence of caries. There are no lesions present in the oral cavity.
Neck: Supple and able to move in all directions without resistance; no cervical lymphadenopathy.
Respiratory: Respiratory rate is 24 breaths per minute, and lungs are clear to auscultation in all lobes. There is good air entry, and no retractions or grunting are noted on examination. No defor-mities of the thoracic cage are noted.
Cardiovascular: Heart rate is 104 beats per minute with a regular rhythm. There is no murmur noted upon auscultation.
Abdomen: Normoactive bowel sounds are present throughout; abdomen is soft and mildly tender in the lower left quadrant. There is no evidence of hepatosplenomegaly.
Genitourinary: Normal female genitalia.
Neuromusculoskeletal: Good tone in all extremities; full range of motion of all extremities.
Extremities are warm and well perfused. Capillary refill is <2 seconds, and spine is straight.
CRITICAL THINKING
Are there laboratory tests or diagnostic imaging studies that should be ordered as part of a workup for abdominal pain?
___Stool test for occult blood___Anorectal manometry
___Digital rectal exam
___Abdominal radiograph
___Blood test for celiac disease
Abdominal Pain 69
___Erythrocyte sedimentation rate (ESR)
___Barium enema
___Total colonic motility studies
___Thyroid function test
___Stool culture
___Endoscopy/Colonoscopy
What is the most likely differential diagnosis and why?
___Functional dyspepsia
___Functional constipation
___Irritable bowel syndrome
___Cyclic vomiting syndrome
___Abdominal migraine
___Functional abdominal pain syndrome
___Gastrointestinal infection
___Hirschsprung disease
___Intussusception
___Celiac disease
___Crohn’s disease
___Dietary intolerances
What is the plan of treatment, referral, and follow‐up care?
Does this patient’s psychosocial history affect how you might treat this case?
What if the patient lived in a rural setting?
Are there any demographic characteristics that might affect this case?
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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