Assignment 1: Lab Assignment: Assessing the Abdomen<\/p>\n
I need help writing my essay – research paper note this assignment is due week 6. I need help writing my essay – research paper refer to your resource list as well as your grading rubrics and study guide for week 6. In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. I need help writing my essay – research paper use your Resource list and grading rubric as a guide. I need help writing my essay – research paper reach out to me if you have any questions regarding this assignment<\/p>\n
ABDOMINAL ASSESSMENT<\/p>\n
Subjective:<\/p>\n
CC: \u201cMy stomach hurts, I have diarrhea and nothing seems to help.\u201d
\nHPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5\/10 today but has been as much as 9\/10 when it first started. He has been able to eat, with some nausea afterwards.
\nPMH: HTN, Diabetes, hx of GI bleed 4 years ago
\nMedications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs
\nAllergies: NKDA
\nFH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD
\nSocial: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)
\nObjective:<\/p>\n
VS: Temp 99.8; BP 160\/86; RR 16; P 92; HT 5\u201910\u201d; WT 248lbs
\nHeart: RRR, no murmurs
\nLungs: CTA, chest wall symmetrical
\nSkin: Intact without lesions, no urticaria
\nAbd: soft, hyperactive bowel sounds, pos pain in the LLQ
\nDiagnostics: None
\nAssessment:<\/p>\n
Left lower quadrant pain
\nGastroenteritis
\nPLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.<\/p>\n
To Prepare<\/p>\n
Review the Episodic note case study your instructor provides you for this week\u2019s Assignment. I need help writing my essay – research paper see the \u201cCourse Announcements\u201d section of the classroom for your Episodic note case study.<\/p>\n
With regard to the Episodic note case study provided:
\nReview this week\u2019s Learning Resources, and consider the insights they provide about the case study.
\nConsider what history would be necessary to collect from the patient in the case study.
\nConsider what physical exams and diagnostic tests would be appropriate to gather more information about the patient\u2019s condition. How would the results be used to make a diagnosis?
\nIdentify at least five possible conditions that may be considered in a differential diagnosis for the patient.
\nThe Assignment<\/p>\n
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
\nAnalyze the objective portion of the note. List additional information that should be included in the documentation.
\nIs the assessment supported by the subjective and objective information? Why or why not?
\nWhat diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
\nWould you reject\/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.<\/p>\n
Rubric Detail<\/p>\n
Select Grid View or List View to change the rubric’s layout.<\/p>\n
Name: NURS_6512_Week_6_Assignment_1_Rubric
\n[removed]<\/p>\n
Grid View
\nList View
\nExcellent\tGood\tFair\tPoor
\nWith regard to the SOAP note case study provided, address the following:<\/p>\n
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
\n10 (10%) – 12 (12%)
\nThe response clearly, accurately, and thoroughly analyzes the subjective portion of the SOAP note and lists detailed additional information to be included in the documentation.
\n7 (7%) – 9 (9%)
\nThe response accurately analyzes the subjective portion of the SOAP note and lists additional information to be included in the documentation.
\n4 (4%) – 6 (6%)
\nThe response vaguely and\/or with some inaccuracy analyzes the subjective portion of the SOAP note and vaguely and\/or with some inaccuracy lists additional information to be included in the documentation.
\n0 (0%) – 3 (3%)
\nThe response inaccurately analyzes or is missing analysis of the subjective portion of the SOAP note, with inaccurate and\/or missing additional information included in the documentation.
\nAnalyze the objective portion of the note. List additional information that should be included in the documentation.
\n10 (10%) – 12 (12%)
\nThe response clearly, accurately, and thoroughly analyzes the objective portion of the SOAP note and lists detailed additional information to be included in the documentation.
\n7 (7%) – 9 (9%)
\nThe response accurately analyzes the objective portion of the SOAP note and lists additional information to be included in the documentation.
\n4 (4%) – 6 (6%)
\nThe response vaguely and\/or with some inaccuracy analyzes the objective portion of the SOAP note and vaguely and\/or inaccurately lists additional information to be included in the documentation.
\n0 (0%) – 3 (3%)
\nThe response inaccurately analyzes or is missing analysis of the objective portion of the SOAP note, with inaccurate and\/or missing additional information included in the documentation.
\nIs the assessment supported by the subjective and objective information? Why or why not?
\n14 (14%) – 16 (16%)
\nThe response clearly and accurately identifies whether or not the assessment is supported by the subjective and\/or objective information, with a thorough and detailed explanation.
\n11 (11%) – 13 (13%)
\nThe response accurately identifies whether or not the assessment is supported by the subjective and\/or objective information, with an explanation.
\n8 (8%) – 10 (10%)
\nThe response vaguely and\/or inaccurately identifies whether or not the assessment is supported by the subjective and\/or objective information, with a vague explanation.
\n0 (0%) – 7 (7%)
\nThe response inaccurately identifies whether or not the assessment is supported by the subjective and\/or objective information, with an inaccurate or missing explanation.
\nWhat diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
\n18 (18%) – 20 (20%)
\nThe response thoroughly and accurately describes appropriate diagnostic tests for the case and explains clearly, thoroughly, and accurately how the test results would be used to make a diagnosis.
\n15 (15%) – 17 (17%)
\nThe response accurately describes appropriate diagnostic tests for the case and explains clearly and accurately how the test results would be used to make a diagnosis.
\n12 (12%) – 14 (14%)
\nThe response vaguely and\/or with some inaccuracy describes appropriate diagnostic tests for the case and vaguely and\/or with some inaccuracy explains how the test results would be used to make a diagnosis.
\n0 (0%) – 11 (11%)
\nThe response inaccurately describes appropriate diagnostic tests for the case, with an inaccurate or missing explanation of how the test results would be used to make a diagnosis.
\n\u00b7 Would you reject or accept the current diagnosis? Why or why not?
\n\u00b7 Identify three possible conditions that may be considered as a differenial diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.
\n23 (23%) – 25 (25%)
\nThe response states clearly whether to accept or reject the current diagnosis, with a thorough, accurate, and detailed explanation of sound reasoning. The response clearly, thoroughly, and accurately identifies three conditions as a differential diagnosis, with reasoning that is explained clearly, accurately, and thoroughly using at least three different references from current evidence-based literature.
\n20 (20%) – 22 (22%)
\nThe response states whether to accept or reject the current diagnosis, with an accurate explanation of sound reasoning. The response accurately identifies three conditions as a differential diagnosis, with reasoning that is explained accurately using three different references from current evidence-based literature.
\n17 (17%) – 19 (19%)
\nThe response states whether to accept or reject the current diagnosis, with a vague explanation of the reasoning. The response identifies two or three conditions as a differential diagnosis, with reasoning that is explained vaguely and\/or inaccurately using three references from current evidence-based literature.
\n0 (0%) – 16 (16%)
\nThe response inaccurately or is missing a statement of whether to accept or reject the current diagnosis, with an explanation that is inaccurate and\/or missing. The response identifies two or fewer conditions as a differential diagnosis, with reasoning that is missing or explained inaccurately using three or fewer references from current evidence-based literature.
\nWritten Expression and Formatting – Paragraph Development and Organization:
\nParagraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
\n5 (5%) – 5 (5%)
\nParagraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
\n4 (4%) – 4 (4%)
\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
\n3 (3%) – 3 (3%)
\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.
\n0 (0%) – 2 (2%)
\nParagraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
\nWritten Expression and Formatting – English writing standards:
\nCorrect grammar, mechanics, and proper punctuation
\n5 (5%) – 5 (5%)
\nUses correct grammar, spelling, and punctuation with no errors.
\n4 (4%) – 4 (4%)
\nContains a few (1 or 2) grammar, spelling, and punctuation errors.
\n3 (3%) – 3 (3%)
\nContains several (3 or 4) grammar, spelling, and punctuation errors.
\n0 (0%) – 2 (2%)
\nContains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.
\nWritten Expression and Formatting – The paper follows correct Ace homework tutors – APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical\/in-text citations, and reference list.
\n5 (5%) – 5 (5%)
\nUses correct Ace homework tutors – APA format with no errors.
\n4 (4%) – 4 (4%)
\nContains a few (1 or 2) Ace homework tutors – APA format errors.
\n3 (3%) – 3 (3%)
\nContains several (3 or 4) Ace homework tutors – APA format errors.
\n0 (0%) – 2 (2%)
\nContains many (\u2265 5) Ace homework tutors – APA format errors.
\nTotal Points: 100
\nName: NURS_6512_Week_6_Assignment_1_Rubric
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