Spontaneous Abortion Case Study Essay Paper
Assignment ID Number AFFGEHU83939HD Type of Document Essay Writing Format APA/MLA/Harvard Academic Level Masters/University References/Sources 4 References
Spontaneous Abortion Case Study Essay Paper
complete the Aquifer case titled Family Medicine 12: 16-year-old female with vaginal bleeding and UCG.
After completing your Aquifer Case Study, answer the following questions using the latest evidenced based guidelines:
Discuss the questions that would be important to include when interviewing a patient with this issue.
• Describe the clinical findings that may be present in a patient with this issue.
• Are there any diagnostic studies that should be ordered on this patient? Why?
• List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.
• Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.
You are working at an outpatient family medicine clinic with Dr. Hill. She has asked you to interview and examine Savannah, a 16-year-old who has come in for a routine sports physical before the softball season begins. Her mother, Leslie, accompanies her.
Dr. Hill informs you, “This is one of the special aspects I love about family medicine: I have cared for Savannah and her entire family since I helped Leslie deliver Savannah 16 years ago!”
She continues, “Today, in addition to performing a pre-participation physical examination, I would like to use this opportunity to perform prevention screening and counseling. Perhaps the most important ‘screening’ issue is the medical interview and developing a safe and trusting doctor-patient relationship. Since this can sometimes be challenging with adolescents, I have found it helpful to organize my interview around the adolescent interviewing mnemonic, HEEADSSS.”
Logistically, you both decide that it would probably be best to begin the history with Savannah’s mother present and then delve into more of the interview after she has been invited to the waiting room during the conclusion of the visit.
Later that morning, Savannah’s laboratory and imaging come back with the following results:
CBC: WBC = 9.3 x103/?L (9.3 x109/L), Hgb = 12.1 g/dL (121 g/L), Hct = 36.3% (0.36), Platelets = 176000/mm3( 176 x109/L)
Wet prep: no trichomonas, no yeast, no clue cells
Quantitative beta-hCG = 1492 mIU/mL
Progesterone = 14.5 nmol/L
Transabdominal and transvaginal ultrasound report:
No intrauterine pregnancy is noted
Left ovarian cyst 3cm
Cannot rule out ectopic pregnancy
Ten days later, you are covering the emergency room with Dr. Hill. The nurse approaches you to inform Dr. Hill that Savannah is here:
Nursing Note:Patient presenting with vaginal bleeding. Her mother says that she is two months pregnant. Her vitals signs are BP 105/75 mmHg, pulse of 90 beats/minute, and a temperature of 36.9 C (98.4 F).”
Dr. Hill thanks the nurse and asks you to accompany her. As you enter the room, Savannah recognizes you and begins to cry. She tells you she has been bleeding on and off for about an hour, with some clots, and a fair amount of pain, but when you ask she tells you she hasn’t had any dizziness or light-headedness.
Dr. Hill says, “Savannah, we need to examine your abdomen and cervix like we did a few weeks ago in the office. Like before, it will involve the speculum to allow us to see, then it will involve a hand in your vagina and another on your abdomen. Is it all right with you if the student performs the exam?”
Savannah responds, “That’s fine. I don’t have any questions yet.”
Dr. Hill assists you in performing a pelvic exam. You find:
Pelvic Exam:Some pooled blood in the vaginal vault. On both the speculum and digital exam, the os appears to be opened to about 1-2 cm. Her abdominal exam reveals normal bowel sounds on auscultation, no tenderness on palpation, and is soft.
Dr. Hill then states to Savannah and Leslie, “I’m going to ask the ultrasound technician to perform another ultrasound, that will allow me to assess the fetus’ heart rate. We should be able to obtain the ultrasound images through your lower abdomen this time.”
Several minutes later, you and Dr. Hill are called to the ultrasound room.
Abdominal Ultrasound: No detectable fetal heart rate. The fetus’ crown-rump length measures 0.65 cm, or approximately 6w4d gestation, similar to the last ultrasound.
“Savannah,” Dr. Hill begins, “your fetus does not have a heartbeat. That means that the fetus has died. I’m sorry.”
Leslie gently but tearfully indicates that they would like a few moments alone.
Dr. Hill excuses you and herself from the room so you may discuss the findings, promising to return in a moment.
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.
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