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  • [Solved] CASE STUDY: OB- Chief Complaint: Prenatal Visit –

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    G6T2P1A2L2, LMP 08/19/2024, EDD: 05/26/2025, who presents today, 1/27/25, – 2 years ago **files (3)** – ## TODO_CASESTUDY.docx – ## NUR-639CaseStudy_Example.docx – Assignment_case_study_guild_use_rubric.docx **## TODO_CASESTUDY.docx** S: **Chief Complaint: Prenatal Visit** – This is a 30-yea…

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    G6T2P1A2L2, LMP 08/19/2024, EDD: 05/26/2025, who presents today, 1/27/25,

    – 2 years ago

    **files (3)**

    – ## TODO_CASESTUDY.docx

    – ## NUR-639CaseStudy_Example.docx

    – Assignment_case_study_guild_use_rubric.docx

    **## TODO_CASESTUDY.docx**

    S:
    **Chief Complaint: Prenatal Visit** –

    This is a 30-year-old Caucasian female G6T2P1A2L2, LMP 08/19/2024, EDD: 05/26/2025, who presents today, 1/27/25, for a prenatal visit, She reports having one complication during previous pregnancies, which resulted in preterm labor; she had regular vaginal deliveries 2 and 4 years ago, resulting in healthy female and male infants weighing 3.3 kg and 3.2 kg, respectively. She experienced two miscarriages in the past two years, one preterm labor, and her current pregnancy is planned. No genetic testing was conducted.

    O: + VSS: No fever + Skin: No unusual lesions or nevi; warm and dry. + External genitalia: Normal female-pattern hair distribution; no lesions or erythema on labia minora, Majora, or introitus. + Vagina: Pink walls with present rugae; no lesions or tears; well estrogenized; serosanguinous discharge noted. + Cervix: Pink and smooth; no lesions, discharge, or bleeding; no polyps or pain. + Fundal height measures 24 cm; FHR 134/min. +FM is regular. Bedside ultrasound shows a single viable fetus in the transverse position with a posterior placenta. Low heartbeat at 89. Breast exam: Right breast inspection shows no nipple discharge, skin discoloration, rashes, dimpling, retraction, tenderness, or masses; no lymphadenopathy. Left breast inspection reveals no nipple discharge, skin discoloration, rashes, dimpling, retraction, tenderness, or masses; no lymphadenopathy. Palpation: Right breast non-tender; axillae free of lymphadenopathy or palpable masses. Left breast non-tender; axillae free of lymphadenopathy or palpable masses.

    A: 23 weeks pregnant; diagnosed with iron-deficiency anemia. Diagnostic: bedside ultrasound.

    P: Scheduled for a hematology appointment next week to address anemia. Discuss topics including nutrition, weight gain, exercise, smoking cessation, alcohol use, domestic violence, and immunizations.

    Pharmacologic: Polydextrose-iron complex (Feramax 150 mg PO OD). Prenatal vitamin

    Non-pharmacologic: Provided education on exercise, fluid intake, prenatal vitamins, and nutrition management. RTC in 4 weeks.

    This is just a sample; don’t use these medications. NOTE:
    **Pharmacology interventions MUST BE IN THIS FORMAT**

    Ciprofloxacin (Cipro) 500 mg tablet orally every 12hrs for seven days

    Acetaminophen 650 mg tablet orally every 4-6 hours as needed.

    Ondansetron (Zofran) 8 mg tablet orally every 12 hours as needed for seven days.

    **APA FORMAT, AND REFERENCES, peer review scholarly resource cited in APA format from 2020-2025 only. (Within the last five years)**

    **Please do not solely use a website as your scholarly reference. It is fine to use it as a supplement, but a journal article or text should be referenced.**

    **Please use North American peer-reviewed journals ONLY.**

    **DO NOT use any European Journal**

    Please use reliable medical references such as the Current Medical Diagnosis and Treatment book or UpToDate. Do not use WebMD, Wikipedia, etc., as these are not advanced practice references.

    APA format (if using outside sources).

    **## NUR-639CaseStudy_Example.docx**

    CASE STUDY & SOAP NOTES 2

    CASE STUDY & SOAP NOTES 2

    CASE STUDY & SOAP NOTES 2

    Cue Study # 3 – ELOG #13590073

    CC: "I nave been having irregular periods for the past 5 months since I have stopped taking my birth control pills."

    HPI: M.A-P is a 30 y/o nulliparous African Canadian female that presents to the clinic today c/o in•egular periods for the paot 5 months after stopping her COC pills. Pt has been taking COC pills for 5 years but decided to stop. Denies trying for pregnancy at this time. Pt LMP 01/08 20. Denies ACHES. Admitted to taking a pregnancy vest the first and third month she missed her period- which was negative. Current means of contraceptives is barrier method of cond nms.

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Admitted to using levonorgestrel pill ( Plan B) one time 2 months ago fo pregnancy prophylaxis y,hich resulted in ha having a period that month since stopping the CDC pills. While on COC pills and prior to its use admits to having regular menses. Menstrual cycle was regular q 28 days, lasting 4-6 days. Denies having any dyspareunia, vaginal discharge, bleeding or odour. Pt has had sexual partners in the past 2 years. Currently denies having dysuria. Denies any fatigue, malaise or fever. of left and right ovarian cysts, anxiety, high cholesterol and hemorrhokds. Last STI and PAP testinp was 2018 – negative. Denies any history of STI's or abnormal PAP's. Denies any N&V, fever. aches and chills. No weight change or change in eating pattern.FMHX; Mother- H TN hyperlipidemia, breast cancer. Father- high cholesterol and ETOT-I abuse. Sister- PCOS, fibroids and diabetes. Brother- healthy
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Referral source: Patient

    Source and Reliability: Patien& came into the clinic on her own today Patient seems like a reliable source.

    Social history: Currently wolking in telecommunications. Denies smoking or use of other illicit drug use. Admits to ETOH 14 glass per week.

    OB/GYN Histor«r :

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) N/lenstrual history: patient got her penod at the age of 13. Pt admits to having regular periods each month Mith the cycle being ever, 28 days lasting 4-6 days, but not in the 5 months ago.

    · Contraception: Was taking COC pills for the past 5 years. Admits to using condoms as well.

    · Cervical and Cytology: Last PAP and STI testing done in 2018.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Pregnancy/obstetric history: No previous pregnancies
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Sexual history: L sexual partners in the last 2 years.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) GYN Problems/ Procedures:

    · Last pap summer of 2018-negative as per the patient. c Ovarian cyst on the left and right side since (2012)

    General Medical History:

    · Medical history: hyperlipidemia (2018). Eczema (2012)

    · Aledication: Alesse 28 PO once a day

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Allergies: No medical or environmental allergies

    · Immunizations: Up to date on immunizations as per the patient.

    · Health Maintenance: Plans to take this year flu vaccine. Pt received Gardasil vaccine (unsure of the year).

    · Family History Mother- HTN, Hyperlipidemia, breast ca. Father- high cholesterol and ETOH abuse. Sister, POOS, fibroids and diabetes. Brother- healthy.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Surgeries/procedures hemorrhoid bands (2016)
    Review of Systems:

    General: Denies any weight loss or admits to feeling fatigued. Denies any fever "r chills. Denies any change in appetite.

    Skin: Admits to having acne around the cheek and chin for the Dast 1 year. Feels that wearing masks because of CD VID has ".orsened lt. Denies an rashes, moles, lesion or sores. Lenies pruritic or dry Dkin. Denies change of colour or ,exture to the skin, hair or nails.

    Head, Eyes, Ears, Nose- Throat UENT):

    Head- Denies headaches, no head injuries
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Eyes, Denies erythema to the eyes. no change in vision. Denies straining or having visual issues.

    Ears- Denies any ear pam, tinnitus or ear drainage.

    Nose- no history of nose bleeds.

    Throat- no sinus issues, frequent colds, nasal stuffiness or nose bleeds. Denies sore throat, voice hoarseness or dental disease.

    Neck: Denies any lumps of the neck. Denies any pain wiLh swallowing. No issues with eating food.

    Breast: Denies any breast nodules or masses. Denies any nipple retraction, skin dimpling, or any changes in moles or skin color and consistency. Denies that she performs self -breast examination.

    Respiratory: Denies any recent cough, sputum, wheezing or SOB. changes in breathing. No documentation of her last cnest-x-ray at this clime.

    Cardiovascular: Denies chesL pain or feeling SOB. No known heart disease or blood high pressure. No paroxysmal noctumal dyspnea. dyspnea, or orthopnea. No palpations or edema of the hanc:L and ankles.

    Gastrointestinal: denies change in appetite, denies nausea or vomiting. denies change in bowel habits. Denies general flatus. No issues with swallowing, No jaundice, gallbladder, liver problems.

    Genitourinary and Gynecology: Admits to having irregular periods for 5 months. No dysuria, dyspareunia or abnormal bleedmg/ spotting. No vagmal discharge, pruritus or odour. Demes pelvic pain.

    Musculoskeletal: denies any joint pains, bone pain or issues with mobilization. No previous fractures .

    Psychiatric: No history of depression, buf has hx of anxiety that managed with cognitive behavioural strategies. Denies and suicidal ideations or Dlans.

    Neurological: Denies tremors or vcrtigo. Denies dizziness or headaches or migraines. No syncope episodes. Denies tremors or involuntary movements. Denies any history of radiation exposure to the head or neck.

    Hematologic: No anemia or history of bruising. No history of nose bleeds or blood transfusion or previous transfusions or reactions. No family history of blood disorders. Endocrine: No history of thyroid trouble or heat or cold intolerance.

    Physical Examination:

    General: M.A-P is a 30 y/o female that presents to the clinic. Patient is well-groomed and dressed during the examination. No signs of distress or use of accessary muscles or pair during this examination. Patient is African Canadian female. No facial yimacing noted. BMI 28.7
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)signs: Temp- 36.2. Celsius (Tympanic) RR- 14 with no distress. HR is regular at 80 beatymin. Pulse oximetrv not available at the clime. B/P 1 12/55, Wt 183 lbs, Ht 5'" ft.

    Neurological: Alert and orientatcd x 3. Speech is clear and with good tone. Steady gait during ambulation in and out of the examination room.

    Skin: Scattered course hair noted around the chin and the umbilical area. Fine light hair noted on two areas of the neck. Darker pigmentation noted to the neck folds, armoits and inner thigh bilaterally. ho rashes to the abdomen or face. Not pale or diaphoretic. Patient is warm to touch, temperature taken, and It was 36.2 Celsius (tympanic). Nails beds are pink. cab refill <2seconds without clubbing or cyanosiu.

    Cardiovascular: Pt is warm to touch, brachial pulses and femoral pulses palpable. Nonnal sl and s2 with no munnur rub or gallop, no heaves or thrills. PMI is non-displaced and located at 5 th intercostal space. Radial pulses 2+ equal bilaterally. Capillary refill less than 2 seconds. No peripheral edema to Iowa and upper extremities. No edema to the limbs. Dorsalis pedls pulse
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)posterior tibial pulses and poplitea[ pulses palpable. Calves are non-tender and not swollen.


    Head, Eyes, Ears, Nose, Throat (HEENT):

    Head: is normocephalic and atraumatic, hair colour is black. Scalp has no lesions. Hair evenly distributed with average texture. No hair loss noted.

    Eyes: conjunctiva pink and sclera are white. During fundus eye examination, red reflex noted, no A-V nicking or arteriolar narrowing. EOM intact.

    Ears: Ears examined with otoscope, tymnanic membranes intact, pearly grey bilaterally and his ear canals have minimal cerumen. TM have cone of light at 7 0'clock for left ear and 5 ( 'clock for right ear.

    Nose: Nasal mucosa is Pink, and septum is No polyps or sinus tenderness, rhinorrhea with clear discharge noted bilaterally.

    Throat: tonsils are bilaterally oral mucosa is moist, no uxudate on the pharynx. Dentition good. tongue and uvula midline.

    Neck: Neck is symmetrical in appearance. other lumps noted in the head, axillae, chest or abdomen. No goiter noted. No masses palpated on thyroid. Denies any difficulty or pain Wth
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)swallowing


    Lymph nodes: No lymphadenopathy noted. No regional lymphadenopathy to the axillary and supraclavicular and infraclavicular.

    Breast:

    Inspection: Breast appears symmetrical In size during the inspection no breast retractions, dimple or creases noted bilaterally. breast straw stretch marks noted. No Peau d 'orange Areola's are symmetrical, no nipple d/c noted. Large aerola dark brown in colour, Montgomery nipple glands noted on breast bilaterally.

    Palpation: Skin warm to touch. No bilateral breast pain during supine palpation. No nipple discharge during palpation. No swelling, redness or edema noted. No lump m the breast bilaterally and no masses and in the tail of spence axil area. No lymphadenopathy of the infraclavicular and supracla-•icular noues.

    Thorax and lungs. Inspection ofthnrax completed elliptical in shape. No retractions or use of accessorv muscles. No crepitus during palpation. Lung expansion bilateral. Tactile fremitus negative. During auscultationu no adventitious sounds noted.

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)Abdomen: Ilyperactive bowel sounds to all four quadrants. Abdomen soft and non-tender. No rebouding guarding noted during the exammatron. No hepatosplenomegaly noted
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Pelvic Exam: Extemal genitalia- hair distribution of nonnal female pattem. No vulvar erythema or lesions. Vaginal mucosa pink, rugae present-no d/c noted . Cervix: pink, cervical os round and centered. no bleeding, DOIyps or cervical d/c. No tenderness to the Bartholin or skene glands. Bimanual: retroverted uterus, uterus mobile, soft and nontender. adnexal tenderness or masses. CMT negative

    Rectal: no extemal hemorrhoids noted

    Assessment: Secondary Amenorrhea -POOS

    · There are multinle causes of secondary amenorrhea. Amenorrhea can be a transient, intermittent, or permanent condition. Comrnon of causes amenorrhea can include dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina.

    · Secondary amenorrhea is the absence of normal menstruation in a patient with a previously established cycle and PCOS presents in 30% of cases of secondary amenorrhea ( Smith & Netter, 2018). Therefore, demonstrating this needs to be ruled out.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) However given the patients presenting symptoms of having regular periods her whole life um-il this change occulted 5 months ago. In addition, family history of PCOS, currently has hirsutism, and is showing signs of acanthosis nigricans which are suggestive of hyperandrogenism leading io a primary differential of POOS.


    Differential Diagnosis

    Primary Differential Diagnosis #1- PCOS to secondary amenorrhea

    Etiology and Clinical findings: PCOS a common endocrine disorder with an etiology that is unknown (Smith & Netter, 2018). Hoy ever, there are studies that have shown there to be a genetic factors and possible auto aomal transmission ( Q mith & Netter, 2018). PCOS does affect 5-10% of women in their reproductive age (McPhee & Papadakis. 2019). It has been noted that POS is linked to increase GnrH and abnormal secretion of FSH and LH resulting in in excess androgen (Smith & Netter, 2018). Therefore, an increase in LA can help with diagnosis of the condition. PCOS is associated with hirsutism, amenorrhea, anovulation, insulin resistance, multicystic ovaries, obesity, risk of diabetes, cardiovascular disease and metabolic syndrome. As per Jarrett et al (2019), Rotterdam Criteria can be used for diagnosis for POOS. This criteria includes androgen production, ovulatory dysfunction and polycystic ovaries. More clinical findings include acanthosis nignicans, acne and apple shaped obesity. In addition, it has been linked to long-term risl- of endometnal cancer.

    Rationale Pertinent Positive and negative:

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Given the above information this patient presents many clinical findings of POOS. The patient has areas of acanthosis nigricans of thc neck and armpits, increased BMI, hirituism, amenorrhea, elevated cholesterol and a family history of PCOS. Pertinent negative in thi e situation that blood work and pelvic un would have to be done first to confirm diagnosis.


    Diagnostic criteria for diagnosis: Please refer to the primary differential plan below

    Differential Diagnosis #2- Functional Hypothalamic / Pituitary causes

    Etiology and Clinical findings: functional hypothalamic dysfunction are contributing cause of amenorrhea for women. Functional hypothalamic dysfunction is also known as functional hypothalamic GnRH deficiency, which is characterized by a presurned decrease in hypothalamic GnRH secretion (McPhee & Papadakis, 2019). Decrease GnRH can lead to a decrease in gonadotropins. FSH, LH, absence of normal follicular development, anovulatlon and low serum estrogen concentrations (McPhee & Papadakis, 2019). One of the most common causes of secondary amenorrhea is from disturbed hypothalamic—pituitary-ovarian axis from stress, weight loss and or excessive physical exercise(Smith & Netter, 2018).. In addition, such eating disorders such as anorexia nervosa or excessive exercise from athletes. The test to distinguish hypothalamic dysfunction from pituitary diseases, where hypogonadism is also characteristic is related to Gnrh.

    According to Smith & Netter( 2018) 35% of cases of secondary amenorrhea is related to functional hypothalan•ic dysfunction. This condition is usually a diagnosis of exclusion, made after ruling out organic diseases. One of the main clinical concems is that it can cause bone loss due hypoestrogenism Another clinical manifestation include weigh, loss or the athlete triad of — amenorrhea, eating disorder, osteoporosis or osteopenia.

    Among pituitary disorders that cause secondary amenorrhea. prolactin-secreting pituitary adenomas prolactinomas are tl• most common.

    Pertinent Positive and negative: pertinent positive is that the patient does demonstra.? irregular periods and it is important to note that 35% of hypothalamic dysfunctions are associated with secondary amenorrhea. However, Pertinent negative is that we do not have any recent blood work or labs to review. In addition, there has been no change in the pt. 's weight to cause weight loss and thvre has been no indication of stress,

    Differential Diagnosis #3- 'Ih•rroid dysfunction

    Etiology and Clinical findings: Ihyroid disease can commonly affect the menstrual cycle of women. As per Mc"hee & Papadakis (2019), it has been seen in 35% of women with hypothyroidism and 3.7 % of women with hyperthyroidism(McPhee & Papadakis 2019), The connection between thyroid hormone levels and the menstrual cycle is mainly mediated by thyrotropin-releasing honnone (TRH), which has a direct effect on the ovaries(McPhee &
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)Papadakis, 2019). Additionally abnormal thyroid function can alter levels of sex hormonebinding globulin, prolactin. and gonadotropin-releasing homone. contributing co menstrual dysfunction (McPhee & Papadakis, 2019). Clinical manifestations for women for hypothyroidism and hyperthyroidism include heavy bleeding patterns, amenorrhea, oligomenorrhea, galactorrhea and decreased Certility (McPhee & Papadakis, 2019).


    Rationale/ Pertinent Positive and negative: This has to be a consideration given that there has been a change in the patient's menstrual cycle. Pertinent positives in this situation include amenorrhea. Pertinent negative there was no indication of heavy periods before or no abnormal nipple discharge, In addition, no history ofhyoer or hypothyroidism.

    Plan of care for Primary differential Diagnosis of PCOS

    · A pregnancy test is recommended as a first in evaluating any woman with secondary amenorrhea. Measurement of serum BhCG is the most sensitive test. Urine ana blood work testing shuuld be done to confirm pregnancy.

    · Goal of care requires dealing with abnormalities that comes with the condition ofPCOS. This includes dealing with anovulatory infertility, metabolic risk factors, obesity and dyslipidemia.

    Testing/Lab:

    l. Blood requisition for L] , FSH, prolactin, GnRH, total thyroid screening, ACTH, serum testerone (total) and DHEA. In addition, lipid panel, glucose, HA I c.

    Diagnostics Criteria: & Imagining:

    2. Tranuvaginal U/S can show ovarian enlargemvnt or presence of multiple small follicles on the ovaries ( pearl of cysts).

    3. As per Jarett ( 2019), Rotterdam criteria for diagnosis includes:

    a. Oligomenorrhea or anovulation

    b. Climcal and biochemical signs of hyperandrogenism

    c. Polycystic ovaries

    Non-Pharmacology
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    4. First line therapy for PCOS included weight loss management that can help retum menstrual function In patients with mild or early PCOS. For patients with obeuity weight reduction and exercise can often reverse the metabolic effects (McPhee & Papadakis, 2019).

    5. Discu„sion with the patient to review restarting COC therapy to prevent unplanned pregnancy in the event anovulation retums. However. the discussion would be lependent if the patient is interested in pregnancy. If patient is considering pregnancy discussion would then be to review medication that would induce ovulation.

    6. E not pursuing pregnancy to manage end ometrial protection from chronic anovulation discussion of resuming COC is first line therapy. In addition, COC provides management for the hirsutism. Consideration for IUD use as it has been effective in minimizing uterine bleeding and endometrial hyperplasia, but not against hirsutism (McPhee & Papadakis, 2019).

    7. For management of dyslipidemia includes exercise weightless and monitoring of Lipid profile.

    Pharmacology:

    8. ICetformin 500 mg PO fi.ice a day( Snith & Netter, 2018)

    0 . Spironolactone 25 mg PO three times a day is useful in treating hirsutism (McPhee & Papadakis, 2019).

    10. I F not managed with exercise and weight reduction a consideration of using statins is important

    I l. COC's are the mainstay of pharmacologic therapy for women with PCOS for managing hyperandrogenism and menstrual dysfunction and For providing contraception.

    Surgical treatment: None

    Patient Education:

    IL. Education should be provided on the importance of monitoring lipid profile and glucose profile (McPhee & Papadakis, 2019).

    13. If patient is considermg pregnancy patient will be advised to stop Spironolactone as it is consid ered a category drug for patients of child bearing potential.

    l l. Explain to the patient that there is some evidence that women with PCOS have impaired quality of life and higher rates of depression and anxiety when compared with women of' snnilar BMI without PCOS. Therefore, education about stress reduction and ways to manage their psychosocial aspect is impollant.

    Follow up:

    15. Normal health maintenance once diagnosis is confirmed is important to implement and to monitor lipid panel. glucose, HA I c.

    16. Patient IS at risk for diabetes. so ongoing discussion of weight control and exercise.

    17, 'Ihe vhronic anovulation seen i n PCOS is associated with an increased risk of endometrial hyperplasia and possibly endometrial cancer. Therefore discussion about rocs as firstline therapy for menstrual dysfunction and endometrial protection ( Jarrett et al, 2019)

    18. Discussed the importance of managing this condition to reduce risk factors for type 2 diabetes and cardiovascular disease, therefore, ongoing review of cardiovascular risk

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)•actors.

    References

    Carcio, H. A. & Secor, R.M (2015). Advanced health assessmen' Qfwomen. 3 rd ed. New York, New York: Springer Dubli$hlng Co.

    Jarrett B.Y., Lin, A-W., Lujan, M (2019). A commentary on the new evidence-basud lifestyle recommendations for patients with polycystic ovary syndrome and potential barriers to their implementation in the united states. Journal 01 the academy of nutrition and dietetics. vol 119(2) 0 05-210

    McPhee, S. & Papadakis M. (2019). Current Medical Diagnosis and Treatment.

    McGraw-Hill Medical Publishers.

    Smith, R. P, & Netter F. H. (2018). Netter's obstetrics and gpnecolog,'. 3rd edition. Philadelphia
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    PA: Elsevier.

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    **Assignment_case_study_guild_use_rubric.docx**

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    **Assignment_case_study_guild_use_rubric.docx**

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    **## TODO_CASESTUDY.docx**

    S:
    **Chief Complaint: Prenatal Visit** –

    This is a 30-year-old Caucasian female G6T2P1A2L2, LMP 08/19/2024, EDD: 05/26/2025, who presents today, 1/27/25, for a prenatal visit, She reports having one complication during previous pregnancies, which resulted in preterm labor; she had regular vaginal deliveries 2 and 4 years ago, resulting in healthy female and male infants weighing 3.3 kg and 3.2 kg, respectively. She experienced two miscarriages in the past two years, one preterm labor, and her current pregnancy is planned. No genetic testing was conducted.

    O: + VSS: No fever + Skin: No unusual lesions or nevi; warm and dry. + External genitalia: Normal female-pattern hair distribution; no lesions or erythema on labia minora, Majora, or introitus. + Vagina: Pink walls with present rugae; no lesions or tears; well estrogenized; serosanguinous discharge noted. + Cervix: Pink and smooth; no lesions, discharge, or bleeding; no polyps or pain. + Fundal height measures 24 cm; FHR 134/min. +FM is regular. Bedside ultrasound shows a single viable fetus in the transverse position with a posterior placenta. Low heartbeat at 89. Breast exam: Right breast inspection shows no nipple discharge, skin discoloration, rashes, dimpling, retraction, tenderness, or masses; no lymphadenopathy. Left breast inspection reveals no nipple discharge, skin discoloration, rashes, dimpling, retraction, tenderness, or masses; no lymphadenopathy. Palpation: Right breast non-tender; axillae free of lymphadenopathy or palpable masses. Left breast non-tender; axillae free of lymphadenopathy or palpable masses.

    A: 23 weeks pregnant; diagnosed with iron-deficiency anemia. Diagnostic: bedside ultrasound.

    P: Scheduled for a hematology appointment next week to address anemia. Discuss topics including nutrition, weight gain, exercise, smoking cessation, alcohol use, domestic violence, and immunizations.

    Pharmacologic: Polydextrose-iron complex (Feramax 150 mg PO OD). Prenatal vitamin

    Non-pharmacologic: Provided education on exercise, fluid intake, prenatal vitamins, and nutrition management. RTC in 4 weeks.

    This is just a sample; don’t use these medications. NOTE:
    **Pharmacology interventions MUST BE IN THIS FORMAT**

    Ciprofloxacin (Cipro) 500 mg tablet orally every 12hrs for seven days

    Acetaminophen 650 mg tablet orally every 4-6 hours as needed.

    Ondansetron (Zofran) 8 mg tablet orally every 12 hours as needed for seven days.

    **APA FORMAT, AND REFERENCES, peer review scholarly resource cited in APA format from 2020-2025 only. (Within the last five years)**

    **Please do not solely use a website as your scholarly reference. It is fine to use it as a supplement, but a journal article or text should be referenced.**

    **Please use North American peer-reviewed journals ONLY.**

    **DO NOT use any European Journal**

    Please use reliable medical references such as the Current Medical Diagnosis and Treatment book or UpToDate. Do not use WebMD, Wikipedia, etc., as these are not advanced practice references.

    APA format (if using outside sources).

    **## NUR-639CaseStudy_Example.docx**

    CASE STUDY & SOAP NOTES 2

    CASE STUDY & SOAP NOTES 2

    CASE STUDY & SOAP NOTES 2

    Cue Study # 3 – ELOG #13590073

    CC: "I nave been having irregular periods for the past 5 months since I have stopped taking my birth control pills."

    HPI: M.A-P is a 30 y/o nulliparous African Canadian female that presents to the clinic today c/o in•egular periods for the paot 5 months after stopping her COC pills. Pt has been taking COC pills for 5 years but decided to stop. Denies trying for pregnancy at this time. Pt LMP 01/08 20. Denies ACHES. Admitted to taking a pregnancy vest the first and third month she missed her period- which was negative. Current means of contraceptives is barrier method of cond nms.

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Admitted to using levonorgestrel pill ( Plan B) one time 2 months ago fo pregnancy prophylaxis y,hich resulted in ha having a period that month since stopping the CDC pills. While on COC pills and prior to its use admits to having regular menses. Menstrual cycle was regular q 28 days, lasting 4-6 days. Denies having any dyspareunia, vaginal discharge, bleeding or odour. Pt has had sexual partners in the past 2 years. Currently denies having dysuria. Denies any fatigue, malaise or fever. of left and right ovarian cysts, anxiety, high cholesterol and hemorrhokds. Last STI and PAP testinp was 2018 – negative. Denies any history of STI's or abnormal PAP's. Denies any N&V, fever. aches and chills. No weight change or change in eating pattern.FMHX; Mother- H TN hyperlipidemia, breast cancer. Father- high cholesterol and ETOT-I abuse. Sister- PCOS, fibroids and diabetes. Brother- healthy
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Referral source: Patient

    Source and Reliability: Patien& came into the clinic on her own today Patient seems like a reliable source.

    Social history: Currently wolking in telecommunications. Denies smoking or use of other illicit drug use. Admits to ETOH 14 glass per week.

    OB/GYN Histor«r :

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) N/lenstrual history: patient got her penod at the age of 13. Pt admits to having regular periods each month Mith the cycle being ever, 28 days lasting 4-6 days, but not in the 5 months ago.

    · Contraception: Was taking COC pills for the past 5 years. Admits to using condoms as well.

    · Cervical and Cytology: Last PAP and STI testing done in 2018.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Pregnancy/obstetric history: No previous pregnancies
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Sexual history: L sexual partners in the last 2 years.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) GYN Problems/ Procedures:

    · Last pap summer of 2018-negative as per the patient. c Ovarian cyst on the left and right side since (2012)

    General Medical History:

    · Medical history: hyperlipidemia (2018). Eczema (2012)

    · Aledication: Alesse 28 PO once a day

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Allergies: No medical or environmental allergies

    · Immunizations: Up to date on immunizations as per the patient.

    · Health Maintenance: Plans to take this year flu vaccine. Pt received Gardasil vaccine (unsure of the year).

    · Family History Mother- HTN, Hyperlipidemia, breast ca. Father- high cholesterol and ETOH abuse. Sister, POOS, fibroids and diabetes. Brother- healthy.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Surgeries/procedures hemorrhoid bands (2016)
    Review of Systems:

    General: Denies any weight loss or admits to feeling fatigued. Denies any fever "r chills. Denies any change in appetite.

    Skin: Admits to having acne around the cheek and chin for the Dast 1 year. Feels that wearing masks because of CD VID has ".orsened lt. Denies an rashes, moles, lesion or sores. Lenies pruritic or dry Dkin. Denies change of colour or ,exture to the skin, hair or nails.

    Head, Eyes, Ears, Nose- Throat UENT):

    Head- Denies headaches, no head injuries
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Eyes, Denies erythema to the eyes. no change in vision. Denies straining or having visual issues.

    Ears- Denies any ear pam, tinnitus or ear drainage.

    Nose- no history of nose bleeds.

    Throat- no sinus issues, frequent colds, nasal stuffiness or nose bleeds. Denies sore throat, voice hoarseness or dental disease.

    Neck: Denies any lumps of the neck. Denies any pain wiLh swallowing. No issues with eating food.

    Breast: Denies any breast nodules or masses. Denies any nipple retraction, skin dimpling, or any changes in moles or skin color and consistency. Denies that she performs self -breast examination.

    Respiratory: Denies any recent cough, sputum, wheezing or SOB. changes in breathing. No documentation of her last cnest-x-ray at this clime.

    Cardiovascular: Denies chesL pain or feeling SOB. No known heart disease or blood high pressure. No paroxysmal noctumal dyspnea. dyspnea, or orthopnea. No palpations or edema of the hanc:L and ankles.

    Gastrointestinal: denies change in appetite, denies nausea or vomiting. denies change in bowel habits. Denies general flatus. No issues with swallowing, No jaundice, gallbladder, liver problems.

    Genitourinary and Gynecology: Admits to having irregular periods for 5 months. No dysuria, dyspareunia or abnormal bleedmg/ spotting. No vagmal discharge, pruritus or odour. Demes pelvic pain.

    Musculoskeletal: denies any joint pains, bone pain or issues with mobilization. No previous fractures .

    Psychiatric: No history of depression, buf has hx of anxiety that managed with cognitive behavioural strategies. Denies and suicidal ideations or Dlans.

    Neurological: Denies tremors or vcrtigo. Denies dizziness or headaches or migraines. No syncope episodes. Denies tremors or involuntary movements. Denies any history of radiation exposure to the head or neck.

    Hematologic: No anemia or history of bruising. No history of nose bleeds or blood transfusion or previous transfusions or reactions. No family history of blood disorders. Endocrine: No history of thyroid trouble or heat or cold intolerance.

    Physical Examination:

    General: M.A-P is a 30 y/o female that presents to the clinic. Patient is well-groomed and dressed during the examination. No signs of distress or use of accessary muscles or pair during this examination. Patient is African Canadian female. No facial yimacing noted. BMI 28.7
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)signs: Temp- 36.2. Celsius (Tympanic) RR- 14 with no distress. HR is regular at 80 beatymin. Pulse oximetrv not available at the clime. B/P 1 12/55, Wt 183 lbs, Ht 5'" ft.

    Neurological: Alert and orientatcd x 3. Speech is clear and with good tone. Steady gait during ambulation in and out of the examination room.

    Skin: Scattered course hair noted around the chin and the umbilical area. Fine light hair noted on two areas of the neck. Darker pigmentation noted to the neck folds, armoits and inner thigh bilaterally. ho rashes to the abdomen or face. Not pale or diaphoretic. Patient is warm to touch, temperature taken, and It was 36.2 Celsius (tympanic). Nails beds are pink. cab refill <2seconds without clubbing or cyanosiu.

    Cardiovascular: Pt is warm to touch, brachial pulses and femoral pulses palpable. Nonnal sl and s2 with no munnur rub or gallop, no heaves or thrills. PMI is non-displaced and located at 5 th intercostal space. Radial pulses 2+ equal bilaterally. Capillary refill less than 2 seconds. No peripheral edema to Iowa and upper extremities. No edema to the limbs. Dorsalis pedls pulse
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)posterior tibial pulses and poplitea[ pulses palpable. Calves are non-tender and not swollen.


    Head, Eyes, Ears, Nose, Throat (HEENT):

    Head: is normocephalic and atraumatic, hair colour is black. Scalp has no lesions. Hair evenly distributed with average texture. No hair loss noted.

    Eyes: conjunctiva pink and sclera are white. During fundus eye examination, red reflex noted, no A-V nicking or arteriolar narrowing. EOM intact.

    Ears: Ears examined with otoscope, tymnanic membranes intact, pearly grey bilaterally and his ear canals have minimal cerumen. TM have cone of light at 7 0'clock for left ear and 5 ( 'clock for right ear.

    Nose: Nasal mucosa is Pink, and septum is No polyps or sinus tenderness, rhinorrhea with clear discharge noted bilaterally.

    Throat: tonsils are bilaterally oral mucosa is moist, no uxudate on the pharynx. Dentition good. tongue and uvula midline.

    Neck: Neck is symmetrical in appearance. other lumps noted in the head, axillae, chest or abdomen. No goiter noted. No masses palpated on thyroid. Denies any difficulty or pain Wth
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)swallowing


    Lymph nodes: No lymphadenopathy noted. No regional lymphadenopathy to the axillary and supraclavicular and infraclavicular.

    Breast:

    Inspection: Breast appears symmetrical In size during the inspection no breast retractions, dimple or creases noted bilaterally. breast straw stretch marks noted. No Peau d 'orange Areola's are symmetrical, no nipple d/c noted. Large aerola dark brown in colour, Montgomery nipple glands noted on breast bilaterally.

    Palpation: Skin warm to touch. No bilateral breast pain during supine palpation. No nipple discharge during palpation. No swelling, redness or edema noted. No lump m the breast bilaterally and no masses and in the tail of spence axil area. No lymphadenopathy of the infraclavicular and supracla-•icular noues.

    Thorax and lungs. Inspection ofthnrax completed elliptical in shape. No retractions or use of accessorv muscles. No crepitus during palpation. Lung expansion bilateral. Tactile fremitus negative. During auscultationu no adventitious sounds noted.

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)Abdomen: Ilyperactive bowel sounds to all four quadrants. Abdomen soft and non-tender. No rebouding guarding noted during the exammatron. No hepatosplenomegaly noted
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Pelvic Exam: Extemal genitalia- hair distribution of nonnal female pattem. No vulvar erythema or lesions. Vaginal mucosa pink, rugae present-no d/c noted . Cervix: pink, cervical os round and centered. no bleeding, DOIyps or cervical d/c. No tenderness to the Bartholin or skene glands. Bimanual: retroverted uterus, uterus mobile, soft and nontender. adnexal tenderness or masses. CMT negative

    Rectal: no extemal hemorrhoids noted

    Assessment: Secondary Amenorrhea -POOS

    · There are multinle causes of secondary amenorrhea. Amenorrhea can be a transient, intermittent, or permanent condition. Comrnon of causes amenorrhea can include dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina.

    · Secondary amenorrhea is the absence of normal menstruation in a patient with a previously established cycle and PCOS presents in 30% of cases of secondary amenorrhea ( Smith & Netter, 2018). Therefore, demonstrating this needs to be ruled out.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) However given the patients presenting symptoms of having regular periods her whole life um-il this change occulted 5 months ago. In addition, family history of PCOS, currently has hirsutism, and is showing signs of acanthosis nigricans which are suggestive of hyperandrogenism leading io a primary differential of POOS.


    Differential Diagnosis

    Primary Differential Diagnosis #1- PCOS to secondary amenorrhea

    Etiology and Clinical findings: PCOS a common endocrine disorder with an etiology that is unknown (Smith & Netter, 2018). Hoy ever, there are studies that have shown there to be a genetic factors and possible auto aomal transmission ( Q mith & Netter, 2018). PCOS does affect 5-10% of women in their reproductive age (McPhee & Papadakis. 2019). It has been noted that POS is linked to increase GnrH and abnormal secretion of FSH and LH resulting in in excess androgen (Smith & Netter, 2018). Therefore, an increase in LA can help with diagnosis of the condition. PCOS is associated with hirsutism, amenorrhea, anovulation, insulin resistance, multicystic ovaries, obesity, risk of diabetes, cardiovascular disease and metabolic syndrome. As per Jarrett et al (2019), Rotterdam Criteria can be used for diagnosis for POOS. This criteria includes androgen production, ovulatory dysfunction and polycystic ovaries. More clinical findings include acanthosis nignicans, acne and apple shaped obesity. In addition, it has been linked to long-term risl- of endometnal cancer.

    Rationale Pertinent Positive and negative:

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Given the above information this patient presents many clinical findings of POOS. The patient has areas of acanthosis nigricans of thc neck and armpits, increased BMI, hirituism, amenorrhea, elevated cholesterol and a family history of PCOS. Pertinent negative in thi e situation that blood work and pelvic un would have to be done first to confirm diagnosis.


    Diagnostic criteria for diagnosis: Please refer to the primary differential plan below

    Differential Diagnosis #2- Functional Hypothalamic / Pituitary causes

    Etiology and Clinical findings: functional hypothalamic dysfunction are contributing cause of amenorrhea for women. Functional hypothalamic dysfunction is also known as functional hypothalamic GnRH deficiency, which is characterized by a presurned decrease in hypothalamic GnRH secretion (McPhee & Papadakis, 2019). Decrease GnRH can lead to a decrease in gonadotropins. FSH, LH, absence of normal follicular development, anovulatlon and low serum estrogen concentrations (McPhee & Papadakis, 2019). One of the most common causes of secondary amenorrhea is from disturbed hypothalamic—pituitary-ovarian axis from stress, weight loss and or excessive physical exercise(Smith & Netter, 2018).. In addition, such eating disorders such as anorexia nervosa or excessive exercise from athletes. The test to distinguish hypothalamic dysfunction from pituitary diseases, where hypogonadism is also characteristic is related to Gnrh.

    According to Smith & Netter( 2018) 35% of cases of secondary amenorrhea is related to functional hypothalan•ic dysfunction. This condition is usually a diagnosis of exclusion, made after ruling out organic diseases. One of the main clinical concems is that it can cause bone loss due hypoestrogenism Another clinical manifestation include weigh, loss or the athlete triad of — amenorrhea, eating disorder, osteoporosis or osteopenia.

    Among pituitary disorders that cause secondary amenorrhea. prolactin-secreting pituitary adenomas prolactinomas are tl• most common.

    Pertinent Positive and negative: pertinent positive is that the patient does demonstra.? irregular periods and it is important to note that 35% of hypothalamic dysfunctions are associated with secondary amenorrhea. However, Pertinent negative is that we do not have any recent blood work or labs to review. In addition, there has been no change in the pt. 's weight to cause weight loss and thvre has been no indication of stress,

    Differential Diagnosis #3- 'Ih•rroid dysfunction

    Etiology and Clinical findings: Ihyroid disease can commonly affect the menstrual cycle of women. As per Mc"hee & Papadakis (2019), it has been seen in 35% of women with hypothyroidism and 3.7 % of women with hyperthyroidism(McPhee & Papadakis 2019), The connection between thyroid hormone levels and the menstrual cycle is mainly mediated by thyrotropin-releasing honnone (TRH), which has a direct effect on the ovaries(McPhee &
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)Papadakis, 2019). Additionally abnormal thyroid function can alter levels of sex hormonebinding globulin, prolactin. and gonadotropin-releasing homone. contributing co menstrual dysfunction (McPhee & Papadakis, 2019). Clinical manifestations for women for hypothyroidism and hyperthyroidism include heavy bleeding patterns, amenorrhea, oligomenorrhea, galactorrhea and decreased Certility (McPhee & Papadakis, 2019).


    Rationale/ Pertinent Positive and negative: This has to be a consideration given that there has been a change in the patient's menstrual cycle. Pertinent positives in this situation include amenorrhea. Pertinent negative there was no indication of heavy periods before or no abnormal nipple discharge, In addition, no history ofhyoer or hypothyroidism.

    Plan of care for Primary differential Diagnosis of PCOS

    · A pregnancy test is recommended as a first in evaluating any woman with secondary amenorrhea. Measurement of serum BhCG is the most sensitive test. Urine ana blood work testing shuuld be done to confirm pregnancy.

    · Goal of care requires dealing with abnormalities that comes with the condition ofPCOS. This includes dealing with anovulatory infertility, metabolic risk factors, obesity and dyslipidemia.

    Testing/Lab:

    l. Blood requisition for L] , FSH, prolactin, GnRH, total thyroid screening, ACTH, serum testerone (total) and DHEA. In addition, lipid panel, glucose, HA I c.

    Diagnostics Criteria: & Imagining:

    2. Tranuvaginal U/S can show ovarian enlargemvnt or presence of multiple small follicles on the ovaries ( pearl of cysts).

    3. As per Jarett ( 2019), Rotterdam criteria for diagnosis includes:

    a. Oligomenorrhea or anovulation

    b. Climcal and biochemical signs of hyperandrogenism

    c. Polycystic ovaries

    Non-Pharmacology
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    4. First line therapy for PCOS included weight loss management that can help retum menstrual function In patients with mild or early PCOS. For patients with obeuity weight reduction and exercise can often reverse the metabolic effects (McPhee & Papadakis, 2019).

    5. Discu„sion with the patient to review restarting COC therapy to prevent unplanned pregnancy in the event anovulation retums. However. the discussion would be lependent if the patient is interested in pregnancy. If patient is considering pregnancy discussion would then be to review medication that would induce ovulation.

    6. E not pursuing pregnancy to manage end ometrial protection from chronic anovulation discussion of resuming COC is first line therapy. In addition, COC provides management for the hirsutism. Consideration for IUD use as it has been effective in minimizing uterine bleeding and endometrial hyperplasia, but not against hirsutism (McPhee & Papadakis, 2019).

    7. For management of dyslipidemia includes exercise weightless and monitoring of Lipid profile.

    Pharmacology:

    8. ICetformin 500 mg PO fi.ice a day( Snith & Netter, 2018)

    0 . Spironolactone 25 mg PO three times a day is useful in treating hirsutism (McPhee & Papadakis, 2019).

    10. I F not managed with exercise and weight reduction a consideration of using statins is important

    I l. COC's are the mainstay of pharmacologic therapy for women with PCOS for managing hyperandrogenism and menstrual dysfunction and For providing contraception.

    Surgical treatment: None

    Patient Education:

    IL. Education should be provided on the importance of monitoring lipid profile and glucose profile (McPhee & Papadakis, 2019).

    13. If patient is considermg pregnancy patient will be advised to stop Spironolactone as it is consid ered a category drug for patients of child bearing potential.

    l l. Explain to the patient that there is some evidence that women with PCOS have impaired quality of life and higher rates of depression and anxiety when compared with women of' snnilar BMI without PCOS. Therefore, education about stress reduction and ways to manage their psychosocial aspect is impollant.

    Follow up:

    15. Normal health maintenance once diagnosis is confirmed is important to implement and to monitor lipid panel. glucose, HA I c.

    16. Patient IS at risk for diabetes. so ongoing discussion of weight control and exercise.

    17, 'Ihe vhronic anovulation seen i n PCOS is associated with an increased risk of endometrial hyperplasia and possibly endometrial cancer. Therefore discussion about rocs as firstline therapy for menstrual dysfunction and endometrial protection ( Jarrett et al, 2019)

    18. Discussed the importance of managing this condition to reduce risk factors for type 2 diabetes and cardiovascular disease, therefore, ongoing review of cardiovascular risk

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)•actors.

    References

    Carcio, H. A. & Secor, R.M (2015). Advanced health assessmen' Qfwomen. 3 rd ed. New York, New York: Springer Dubli$hlng Co.

    Jarrett B.Y., Lin, A-W., Lujan, M (2019). A commentary on the new evidence-basud lifestyle recommendations for patients with polycystic ovary syndrome and potential barriers to their implementation in the united states. Journal 01 the academy of nutrition and dietetics. vol 119(2) 0 05-210

    McPhee, S. & Papadakis M. (2019). Current Medical Diagnosis and Treatment.

    McGraw-Hill Medical Publishers.

    Smith, R. P, & Netter F. H. (2018). Netter's obstetrics and gpnecolog,'. 3rd edition. Philadelphia
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    PA: Elsevier.

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    **Assignment_case_study_guild_use_rubric.docx**

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    **## TODO_CASESTUDY.docx**

    S:
    **Chief Complaint: Prenatal Visit** –

    This is a 30-year-old Caucasian female G6T2P1A2L2, LMP 08/19/2024, EDD: 05/26/2025, who presents today, 1/27/25, for a prenatal visit, She reports having one complication during previous pregnancies, which resulted in preterm labor; she had regular vaginal deliveries 2 and 4 years ago, resulting in healthy female and male infants weighing 3.3 kg and 3.2 kg, respectively. She experienced two miscarriages in the past two years, one preterm labor, and her current pregnancy is planned. No genetic testing was conducted.

    O: + VSS: No fever + Skin: No unusual lesions or nevi; warm and dry. + External genitalia: Normal female-pattern hair distribution; no lesions or erythema on labia minora, Majora, or introitus. + Vagina: Pink walls with present rugae; no lesions or tears; well estrogenized; serosanguinous discharge noted. + Cervix: Pink and smooth; no lesions, discharge, or bleeding; no polyps or pain. + Fundal height measures 24 cm; FHR 134/min. +FM is regular. Bedside ultrasound shows a single viable fetus in the transverse position with a posterior placenta. Low heartbeat at 89. Breast exam: Right breast inspection shows no nipple discharge, skin discoloration, rashes, dimpling, retraction, tenderness, or masses; no lymphadenopathy. Left breast inspection reveals no nipple discharge, skin discoloration, rashes, dimpling, retraction, tenderness, or masses; no lymphadenopathy. Palpation: Right breast non-tender; axillae free of lymphadenopathy or palpable masses. Left breast non-tender; axillae free of lymphadenopathy or palpable masses.

    A: 23 weeks pregnant; diagnosed with iron-deficiency anemia. Diagnostic: bedside ultrasound.

    P: Scheduled for a hematology appointment next week to address anemia. Discuss topics including nutrition, weight gain, exercise, smoking cessation, alcohol use, domestic violence, and immunizations.

    Pharmacologic: Polydextrose-iron complex (Feramax 150 mg PO OD). Prenatal vitamin

    Non-pharmacologic: Provided education on exercise, fluid intake, prenatal vitamins, and nutrition management. RTC in 4 weeks.

    This is just a sample; don’t use these medications. NOTE:
    **Pharmacology interventions MUST BE IN THIS FORMAT**

    Ciprofloxacin (Cipro) 500 mg tablet orally every 12hrs for seven days

    Acetaminophen 650 mg tablet orally every 4-6 hours as needed.

    Ondansetron (Zofran) 8 mg tablet orally every 12 hours as needed for seven days.

    **APA FORMAT, AND REFERENCES, peer review scholarly resource cited in APA format from 2020-2025 only. (Within the last five years)**

    **Please do not solely use a website as your scholarly reference. It is fine to use it as a supplement, but a journal article or text should be referenced.**

    **Please use North American peer-reviewed journals ONLY.**

    **DO NOT use any European Journal**

    Please use reliable medical references such as the Current Medical Diagnosis and Treatment book or UpToDate. Do not use WebMD, Wikipedia, etc., as these are not advanced practice references.

    APA format (if using outside sources).

    **## NUR-639CaseStudy_Example.docx**

    CASE STUDY & SOAP NOTES 2

    CASE STUDY & SOAP NOTES 2

    CASE STUDY & SOAP NOTES 2

    Cue Study # 3 – ELOG #13590073

    CC: "I nave been having irregular periods for the past 5 months since I have stopped taking my birth control pills."

    HPI: M.A-P is a 30 y/o nulliparous African Canadian female that presents to the clinic today c/o in•egular periods for the paot 5 months after stopping her COC pills. Pt has been taking COC pills for 5 years but decided to stop. Denies trying for pregnancy at this time. Pt LMP 01/08 20. Denies ACHES. Admitted to taking a pregnancy vest the first and third month she missed her period- which was negative. Current means of contraceptives is barrier method of cond nms.

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Admitted to using levonorgestrel pill ( Plan B) one time 2 months ago fo pregnancy prophylaxis y,hich resulted in ha having a period that month since stopping the CDC pills. While on COC pills and prior to its use admits to having regular menses. Menstrual cycle was regular q 28 days, lasting 4-6 days. Denies having any dyspareunia, vaginal discharge, bleeding or odour. Pt has had sexual partners in the past 2 years. Currently denies having dysuria. Denies any fatigue, malaise or fever. of left and right ovarian cysts, anxiety, high cholesterol and hemorrhokds. Last STI and PAP testinp was 2018 – negative. Denies any history of STI's or abnormal PAP's. Denies any N&V, fever. aches and chills. No weight change or change in eating pattern.FMHX; Mother- H TN hyperlipidemia, breast cancer. Father- high cholesterol and ETOT-I abuse. Sister- PCOS, fibroids and diabetes. Brother- healthy
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Referral source: Patient

    Source and Reliability: Patien& came into the clinic on her own today Patient seems like a reliable source.

    Social history: Currently wolking in telecommunications. Denies smoking or use of other illicit drug use. Admits to ETOH 14 glass per week.

    OB/GYN Histor«r :

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) N/lenstrual history: patient got her penod at the age of 13. Pt admits to having regular periods each month Mith the cycle being ever, 28 days lasting 4-6 days, but not in the 5 months ago.

    · Contraception: Was taking COC pills for the past 5 years. Admits to using condoms as well.

    · Cervical and Cytology: Last PAP and STI testing done in 2018.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Pregnancy/obstetric history: No previous pregnancies
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Sexual history: L sexual partners in the last 2 years.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) GYN Problems/ Procedures:

    · Last pap summer of 2018-negative as per the patient. c Ovarian cyst on the left and right side since (2012)

    General Medical History:

    · Medical history: hyperlipidemia (2018). Eczema (2012)

    · Aledication: Alesse 28 PO once a day

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Allergies: No medical or environmental allergies

    · Immunizations: Up to date on immunizations as per the patient.

    · Health Maintenance: Plans to take this year flu vaccine. Pt received Gardasil vaccine (unsure of the year).

    · Family History Mother- HTN, Hyperlipidemia, breast ca. Father- high cholesterol and ETOH abuse. Sister, POOS, fibroids and diabetes. Brother- healthy.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Surgeries/procedures hemorrhoid bands (2016)
    Review of Systems:

    General: Denies any weight loss or admits to feeling fatigued. Denies any fever "r chills. Denies any change in appetite.

    Skin: Admits to having acne around the cheek and chin for the Dast 1 year. Feels that wearing masks because of CD VID has ".orsened lt. Denies an rashes, moles, lesion or sores. Lenies pruritic or dry Dkin. Denies change of colour or ,exture to the skin, hair or nails.

    Head, Eyes, Ears, Nose- Throat UENT):

    Head- Denies headaches, no head injuries
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Eyes, Denies erythema to the eyes. no change in vision. Denies straining or having visual issues.

    Ears- Denies any ear pam, tinnitus or ear drainage.

    Nose- no history of nose bleeds.

    Throat- no sinus issues, frequent colds, nasal stuffiness or nose bleeds. Denies sore throat, voice hoarseness or dental disease.

    Neck: Denies any lumps of the neck. Denies any pain wiLh swallowing. No issues with eating food.

    Breast: Denies any breast nodules or masses. Denies any nipple retraction, skin dimpling, or any changes in moles or skin color and consistency. Denies that she performs self -breast examination.

    Respiratory: Denies any recent cough, sputum, wheezing or SOB. changes in breathing. No documentation of her last cnest-x-ray at this clime.

    Cardiovascular: Denies chesL pain or feeling SOB. No known heart disease or blood high pressure. No paroxysmal noctumal dyspnea. dyspnea, or orthopnea. No palpations or edema of the hanc:L and ankles.

    Gastrointestinal: denies change in appetite, denies nausea or vomiting. denies change in bowel habits. Denies general flatus. No issues with swallowing, No jaundice, gallbladder, liver problems.

    Genitourinary and Gynecology: Admits to having irregular periods for 5 months. No dysuria, dyspareunia or abnormal bleedmg/ spotting. No vagmal discharge, pruritus or odour. Demes pelvic pain.

    Musculoskeletal: denies any joint pains, bone pain or issues with mobilization. No previous fractures .

    Psychiatric: No history of depression, buf has hx of anxiety that managed with cognitive behavioural strategies. Denies and suicidal ideations or Dlans.

    Neurological: Denies tremors or vcrtigo. Denies dizziness or headaches or migraines. No syncope episodes. Denies tremors or involuntary movements. Denies any history of radiation exposure to the head or neck.

    Hematologic: No anemia or history of bruising. No history of nose bleeds or blood transfusion or previous transfusions or reactions. No family history of blood disorders. Endocrine: No history of thyroid trouble or heat or cold intolerance.

    Physical Examination:

    General: M.A-P is a 30 y/o female that presents to the clinic. Patient is well-groomed and dressed during the examination. No signs of distress or use of accessary muscles or pair during this examination. Patient is African Canadian female. No facial yimacing noted. BMI 28.7
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)signs: Temp- 36.2. Celsius (Tympanic) RR- 14 with no distress. HR is regular at 80 beatymin. Pulse oximetrv not available at the clime. B/P 1 12/55, Wt 183 lbs, Ht 5'" ft.

    Neurological: Alert and orientatcd x 3. Speech is clear and with good tone. Steady gait during ambulation in and out of the examination room.

    Skin: Scattered course hair noted around the chin and the umbilical area. Fine light hair noted on two areas of the neck. Darker pigmentation noted to the neck folds, armoits and inner thigh bilaterally. ho rashes to the abdomen or face. Not pale or diaphoretic. Patient is warm to touch, temperature taken, and It was 36.2 Celsius (tympanic). Nails beds are pink. cab refill <2seconds without clubbing or cyanosiu.

    Cardiovascular: Pt is warm to touch, brachial pulses and femoral pulses palpable. Nonnal sl and s2 with no munnur rub or gallop, no heaves or thrills. PMI is non-displaced and located at 5 th intercostal space. Radial pulses 2+ equal bilaterally. Capillary refill less than 2 seconds. No peripheral edema to Iowa and upper extremities. No edema to the limbs. Dorsalis pedls pulse
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)posterior tibial pulses and poplitea[ pulses palpable. Calves are non-tender and not swollen.


    Head, Eyes, Ears, Nose, Throat (HEENT):

    Head: is normocephalic and atraumatic, hair colour is black. Scalp has no lesions. Hair evenly distributed with average texture. No hair loss noted.

    Eyes: conjunctiva pink and sclera are white. During fundus eye examination, red reflex noted, no A-V nicking or arteriolar narrowing. EOM intact.

    Ears: Ears examined with otoscope, tymnanic membranes intact, pearly grey bilaterally and his ear canals have minimal cerumen. TM have cone of light at 7 0'clock for left ear and 5 ( 'clock for right ear.

    Nose: Nasal mucosa is Pink, and septum is No polyps or sinus tenderness, rhinorrhea with clear discharge noted bilaterally.

    Throat: tonsils are bilaterally oral mucosa is moist, no uxudate on the pharynx. Dentition good. tongue and uvula midline.

    Neck: Neck is symmetrical in appearance. other lumps noted in the head, axillae, chest or abdomen. No goiter noted. No masses palpated on thyroid. Denies any difficulty or pain Wth
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)swallowing


    Lymph nodes: No lymphadenopathy noted. No regional lymphadenopathy to the axillary and supraclavicular and infraclavicular.

    Breast:

    Inspection: Breast appears symmetrical In size during the inspection no breast retractions, dimple or creases noted bilaterally. breast straw stretch marks noted. No Peau d 'orange Areola's are symmetrical, no nipple d/c noted. Large aerola dark brown in colour, Montgomery nipple glands noted on breast bilaterally.

    Palpation: Skin warm to touch. No bilateral breast pain during supine palpation. No nipple discharge during palpation. No swelling, redness or edema noted. No lump m the breast bilaterally and no masses and in the tail of spence axil area. No lymphadenopathy of the infraclavicular and supracla-•icular noues.

    Thorax and lungs. Inspection ofthnrax completed elliptical in shape. No retractions or use of accessorv muscles. No crepitus during palpation. Lung expansion bilateral. Tactile fremitus negative. During auscultationu no adventitious sounds noted.

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)Abdomen: Ilyperactive bowel sounds to all four quadrants. Abdomen soft and non-tender. No rebouding guarding noted during the exammatron. No hepatosplenomegaly noted
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    Pelvic Exam: Extemal genitalia- hair distribution of nonnal female pattem. No vulvar erythema or lesions. Vaginal mucosa pink, rugae present-no d/c noted . Cervix: pink, cervical os round and centered. no bleeding, DOIyps or cervical d/c. No tenderness to the Bartholin or skene glands. Bimanual: retroverted uterus, uterus mobile, soft and nontender. adnexal tenderness or masses. CMT negative

    Rectal: no extemal hemorrhoids noted

    Assessment: Secondary Amenorrhea -POOS

    · There are multinle causes of secondary amenorrhea. Amenorrhea can be a transient, intermittent, or permanent condition. Comrnon of causes amenorrhea can include dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina.

    · Secondary amenorrhea is the absence of normal menstruation in a patient with a previously established cycle and PCOS presents in 30% of cases of secondary amenorrhea ( Smith & Netter, 2018). Therefore, demonstrating this needs to be ruled out.
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) However given the patients presenting symptoms of having regular periods her whole life um-il this change occulted 5 months ago. In addition, family history of PCOS, currently has hirsutism, and is showing signs of acanthosis nigricans which are suggestive of hyperandrogenism leading io a primary differential of POOS.


    Differential Diagnosis

    Primary Differential Diagnosis #1- PCOS to secondary amenorrhea

    Etiology and Clinical findings: PCOS a common endocrine disorder with an etiology that is unknown (Smith & Netter, 2018). Hoy ever, there are studies that have shown there to be a genetic factors and possible auto aomal transmission ( Q mith & Netter, 2018). PCOS does affect 5-10% of women in their reproductive age (McPhee & Papadakis. 2019). It has been noted that POS is linked to increase GnrH and abnormal secretion of FSH and LH resulting in in excess androgen (Smith & Netter, 2018). Therefore, an increase in LA can help with diagnosis of the condition. PCOS is associated with hirsutism, amenorrhea, anovulation, insulin resistance, multicystic ovaries, obesity, risk of diabetes, cardiovascular disease and metabolic syndrome. As per Jarrett et al (2019), Rotterdam Criteria can be used for diagnosis for POOS. This criteria includes androgen production, ovulatory dysfunction and polycystic ovaries. More clinical findings include acanthosis nignicans, acne and apple shaped obesity. In addition, it has been linked to long-term risl- of endometnal cancer.

    Rationale Pertinent Positive and negative:

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit) Given the above information this patient presents many clinical findings of POOS. The patient has areas of acanthosis nigricans of thc neck and armpits, increased BMI, hirituism, amenorrhea, elevated cholesterol and a family history of PCOS. Pertinent negative in thi e situation that blood work and pelvic un would have to be done first to confirm diagnosis.


    Diagnostic criteria for diagnosis: Please refer to the primary differential plan below

    Differential Diagnosis #2- Functional Hypothalamic / Pituitary causes

    Etiology and Clinical findings: functional hypothalamic dysfunction are contributing cause of amenorrhea for women. Functional hypothalamic dysfunction is also known as functional hypothalamic GnRH deficiency, which is characterized by a presurned decrease in hypothalamic GnRH secretion (McPhee & Papadakis, 2019). Decrease GnRH can lead to a decrease in gonadotropins. FSH, LH, absence of normal follicular development, anovulatlon and low serum estrogen concentrations (McPhee & Papadakis, 2019). One of the most common causes of secondary amenorrhea is from disturbed hypothalamic—pituitary-ovarian axis from stress, weight loss and or excessive physical exercise(Smith & Netter, 2018).. In addition, such eating disorders such as anorexia nervosa or excessive exercise from athletes. The test to distinguish hypothalamic dysfunction from pituitary diseases, where hypogonadism is also characteristic is related to Gnrh.

    According to Smith & Netter( 2018) 35% of cases of secondary amenorrhea is related to functional hypothalan•ic dysfunction. This condition is usually a diagnosis of exclusion, made after ruling out organic diseases. One of the main clinical concems is that it can cause bone loss due hypoestrogenism Another clinical manifestation include weigh, loss or the athlete triad of — amenorrhea, eating disorder, osteoporosis or osteopenia.

    Among pituitary disorders that cause secondary amenorrhea. prolactin-secreting pituitary adenomas prolactinomas are tl• most common.

    Pertinent Positive and negative: pertinent positive is that the patient does demonstra.? irregular periods and it is important to note that 35% of hypothalamic dysfunctions are associated with secondary amenorrhea. However, Pertinent negative is that we do not have any recent blood work or labs to review. In addition, there has been no change in the pt. 's weight to cause weight loss and thvre has been no indication of stress,

    Differential Diagnosis #3- 'Ih•rroid dysfunction

    Etiology and Clinical findings: Ihyroid disease can commonly affect the menstrual cycle of women. As per Mc"hee & Papadakis (2019), it has been seen in 35% of women with hypothyroidism and 3.7 % of women with hyperthyroidism(McPhee & Papadakis 2019), The connection between thyroid hormone levels and the menstrual cycle is mainly mediated by thyrotropin-releasing honnone (TRH), which has a direct effect on the ovaries(McPhee &
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)Papadakis, 2019). Additionally abnormal thyroid function can alter levels of sex hormonebinding globulin, prolactin. and gonadotropin-releasing homone. contributing co menstrual dysfunction (McPhee & Papadakis, 2019). Clinical manifestations for women for hypothyroidism and hyperthyroidism include heavy bleeding patterns, amenorrhea, oligomenorrhea, galactorrhea and decreased Certility (McPhee & Papadakis, 2019).


    Rationale/ Pertinent Positive and negative: This has to be a consideration given that there has been a change in the patient's menstrual cycle. Pertinent positives in this situation include amenorrhea. Pertinent negative there was no indication of heavy periods before or no abnormal nipple discharge, In addition, no history ofhyoer or hypothyroidism.

    Plan of care for Primary differential Diagnosis of PCOS

    · A pregnancy test is recommended as a first in evaluating any woman with secondary amenorrhea. Measurement of serum BhCG is the most sensitive test. Urine ana blood work testing shuuld be done to confirm pregnancy.

    · Goal of care requires dealing with abnormalities that comes with the condition ofPCOS. This includes dealing with anovulatory infertility, metabolic risk factors, obesity and dyslipidemia.

    Testing/Lab:

    l. Blood requisition for L] , FSH, prolactin, GnRH, total thyroid screening, ACTH, serum testerone (total) and DHEA. In addition, lipid panel, glucose, HA I c.

    Diagnostics Criteria: & Imagining:

    2. Tranuvaginal U/S can show ovarian enlargemvnt or presence of multiple small follicles on the ovaries ( pearl of cysts).

    3. As per Jarett ( 2019), Rotterdam criteria for diagnosis includes:

    a. Oligomenorrhea or anovulation

    b. Climcal and biochemical signs of hyperandrogenism

    c. Polycystic ovaries

    Non-Pharmacology
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    4. First line therapy for PCOS included weight loss management that can help retum menstrual function In patients with mild or early PCOS. For patients with obeuity weight reduction and exercise can often reverse the metabolic effects (McPhee & Papadakis, 2019).

    5. Discu„sion with the patient to review restarting COC therapy to prevent unplanned pregnancy in the event anovulation retums. However. the discussion would be lependent if the patient is interested in pregnancy. If patient is considering pregnancy discussion would then be to review medication that would induce ovulation.

    6. E not pursuing pregnancy to manage end ometrial protection from chronic anovulation discussion of resuming COC is first line therapy. In addition, COC provides management for the hirsutism. Consideration for IUD use as it has been effective in minimizing uterine bleeding and endometrial hyperplasia, but not against hirsutism (McPhee & Papadakis, 2019).

    7. For management of dyslipidemia includes exercise weightless and monitoring of Lipid profile.

    Pharmacology:

    8. ICetformin 500 mg PO fi.ice a day( Snith & Netter, 2018)

    0 . Spironolactone 25 mg PO three times a day is useful in treating hirsutism (McPhee & Papadakis, 2019).

    10. I F not managed with exercise and weight reduction a consideration of using statins is important

    I l. COC's are the mainstay of pharmacologic therapy for women with PCOS for managing hyperandrogenism and menstrual dysfunction and For providing contraception.

    Surgical treatment: None

    Patient Education:

    IL. Education should be provided on the importance of monitoring lipid profile and glucose profile (McPhee & Papadakis, 2019).

    13. If patient is considermg pregnancy patient will be advised to stop Spironolactone as it is consid ered a category drug for patients of child bearing potential.

    l l. Explain to the patient that there is some evidence that women with PCOS have impaired quality of life and higher rates of depression and anxiety when compared with women of' snnilar BMI without PCOS. Therefore, education about stress reduction and ways to manage their psychosocial aspect is impollant.

    Follow up:

    15. Normal health maintenance once diagnosis is confirmed is important to implement and to monitor lipid panel. glucose, HA I c.

    16. Patient IS at risk for diabetes. so ongoing discussion of weight control and exercise.

    17, 'Ihe vhronic anovulation seen i n PCOS is associated with an increased risk of endometrial hyperplasia and possibly endometrial cancer. Therefore discussion about rocs as firstline therapy for menstrual dysfunction and endometrial protection ( Jarrett et al, 2019)

    18. Discussed the importance of managing this condition to reduce risk factors for type 2 diabetes and cardiovascular disease, therefore, ongoing review of cardiovascular risk

    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)•actors.

    References

    Carcio, H. A. & Secor, R.M (2015). Advanced health assessmen' Qfwomen. 3 rd ed. New York, New York: Springer Dubli$hlng Co.

    Jarrett B.Y., Lin, A-W., Lujan, M (2019). A commentary on the new evidence-basud lifestyle recommendations for patients with polycystic ovary syndrome and potential barriers to their implementation in the united states. Journal 01 the academy of nutrition and dietetics. vol 119(2) 0 05-210

    McPhee, S. & Papadakis M. (2019). Current Medical Diagnosis and Treatment.

    McGraw-Hill Medical Publishers.

    Smith, R. P, & Netter F. H. (2018). Netter's obstetrics and gpnecolog,'. 3rd edition. Philadelphia
    ![](https://www.sweetstudy.com/questions/case-study-ob-chief-complaint-prenatal-visit)

    PA: Elsevier.

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  • [Solved] Gastrec

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    Mr. Ahmadi, an out-of-shape 45-year-old man, was advised by his physician to lose weight and to exercise on a regular basis. He followed his diet faithfully and began to jog daily. One day, while on his morning jog, he heard a snapping sound that was immediately followed by a severe pain in his righ…

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    Assignment Prompt & Instructions

    Mr. Ahmadi, an out-of-shape 45-year-old man, was advised by his physician to lose weight and to exercise on a regular basis. He followed his diet faithfully and began to jog daily. One day, while on his morning jog, he heard a snapping sound that was immediately followed by a severe pain in his right lower calf. When his leg was examined, a gap was seen between his swollen upper calf region and his heel. He was unable to plantar flex that ankle.

    What do you think happened?

    Why was the upper part of his calf swollen?

    – 2 years ago

  • [Solved] CASE STUDY 1_PEDIATRICS

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    Executive Solution Overview

    Reports hard stools, straining, and discomfort but denies – 2 years ago **files (3)** – ## CASE_STUDY_GUILD_638.docx – ## CaseStudy_Sample_ade.docx – ## N638CaseStudyGradingRubric_2025.docx **## CASE_STUDY_GUILD_638.docx** **NUR 638 – CASE STUDY FORMAT** CC: (6yo male with cough X 1 week) H…

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    Reports hard stools, straining, and discomfort but denies

    – 2 years ago

    **files (3)**

    – ## CASE_STUDY_GUILD_638.docx

    – ## CaseStudy_Sample_ade.docx

    – ## N638CaseStudyGradingRubric_2025.docx

    **## CASE_STUDY_GUILD_638.docx**

    **NUR 638 – CASE STUDY FORMAT**

    CC: (6yo male with cough X 1 week)

    HPI – history of present illness. This is subjective data that the patient or parent is telling you about the illness. It is the “story” of why the patient is coming to see you, include anything that is relevant (such as co-morbidities).

    Example: 5yo female with history of asthma brought to the clinic by mother for c/o cough for 5 days, worse at night. Cough sounds barky. Mother also reports the patient is wheezing and short of breath when engaging in activity. Also has a runny nose and sore throat. Had a fever of 102 yesterday but none today. Cough is worse at night. Drinking well, urinating normally. Siblings are also sick.

    PMH – past medical history (include gestation, ie. prematurity and delivery problems if pertinent)

    Surgical history

    Family history

    Medications (name of medication, dose, indication) use prescriptive format

    Immunizations

    Social or Home situation – who do they live with, siblings, pets (pertinent for respiratory or allergy complaints), smoking. For the well visit you would go over the developmental milestones.

    ROS-review of systems: review all of the pertinent body systems (even if you covered it in the HPI). For the well visit, you will need to do a complete ROS.

    Physical exam: complete if a well child, pertinent systems for a specific complaint. However, EVERY patient should have a Respiratory and Cardiovascular assessment. You will include vital signs and the results of any diagnostic testing.

    Include age appropriate developmental assessment, including milestones and stages.

    Differential Diagnoses: What disease do you think is causing the symptoms? List your primary or working diagnosis first. Include 3 differentials with supporting pathology. You can put pertinent positives and negatives to support your diagnosis.

    Plan of Care: Include everything that you will do for this patient. Medications, written in prescriptive format (dose, route, frequency, duration, indication). Any lab work or diagnostic testing that you will order. Non pharmacologic therapies. Patient teaching including things the patient can do to prevent disease transmission, symptoms that you would want the patient to watch for and what to do if they occur. Follow up directions – including a time frame and who/where they should go. Remember for your Well Visit you will need to discuss anticipatory guidance!

    Reference your sources using APA format. Use your advanced practice journal article for pathophysiology or treatment plan information for the diagnosis.

    Follow the grading rubric. Some of these case studies will be long. As always, speak to your assigned faculty if you have any questions.

    **## CaseStudy_Sample_ade.docx**

    7

    **History:**

    CC: 3-year-old. Male with R. Eye Redness x 4 days.

    HPI:Z.O. is a 3-year-old M with no significant PMH who presents to the office for a sick visit—accompanied by his mom. Mom complained of redness in the Right eye for 4 days. Mom reports that the patient started c/o clear drainage, pain in the Right eye 4 days ago and noticed redness 2 days ago accompanied by itching.  She applied warm compresses and has been given cetirizine for 2 days now with no improvement. Mom denies any contact with anyone who has pink eye. Denies yellow drainage, crusting eye, and closing of the eyelid. Denies any cold symptoms. Denies any visual changes or trauma to the eye. The patient has remained afebrile. He has average oral intake and urine output. Pt currently goes to Head Start, but there is no report of any student with pink eye. Z.O. has no active medications or known drug or food allergies.

    **Diet:** He likes to eat Somali food, pizza, rice, and vegetables.

    **Elimination**: He is fully potty trained.

    **Sleep:** Pt Sleep from 10 pm- 7 am

    **Behavior:** Social interaction is age-appropriate. Once the patient becomes familiar with the situation, he will make friends in new places—no concerns from school or parents.

    **Development:** The child paid appropriate attention and was involved in the exam. Developmentally appropriate.

    **Speech:** Child speech is developmentally appropriate, spontaneous, smooth, and articulate. The primary language in the family is English, and the child speaks English.

    **Social hx**: Z.O. lives with his Parent and two sisters. Like to play with his sibling. Also in head start and participate in class with friends. Home is smoke-free and pet-free

    **PMH**: Mom reports full-term birth with no complications. No surgical history. No significant family history. No active medications.

    Immunizations reviewed and up to date.

    **ROS**:

    **General:** Healthy-appearing, well-nourished, and alert child.

    **Skin**: Denies skin, hair, and nail symptoms.

    **HEENT**: No history of head injury.
    _Eyes_: Reports erythema of the R. Eye and mild swelling.
    _Ears_: Hearing good. No tinnitus, vertigo, infections.
    _Nose_: No hay fever or sinus trouble.
    _Throat_: No tooth pain or gum bleeding.

    **Neck**: No lumps, goiter, pain. No swollen glands.

    **Cardiovascular**: No chest pain, palpitations, dyspnea, orthopnea.

    **Respiratory**: No cough, wheezing, shortness of breath.

    **Physical exam**:

    Vitals: T: 98.7 Wt: 33lb 3oz Wt kg: 15.054 Pulse: 105 Resp: 25 O2SatR: 99

    **General:** Healthy appearing child. Well-nourished and alert. Weighs within the normal range. Mucous membranes are moist and pink. Respiratory pattern is unremarkable. No grunting or nasal flaring.

    **Head and face**: The size of the skull is developmentally appropriate and is in proportion to the rest of the body. Facial move symmetrically and are midline. There is no evidence of dropping, asymmetry, or disproportionate features.

    **Eye:** The conjunctivae show clear white discharge, erythema, and mild swelling in the right eye. The pupil is equal, round, and reactive to light and accommodation. The sclera is clear and anicteric. There is no pain with extraocular movement. Left eye: No abnormalities are noted in the left eye; it appears unaffected.

    **Neck**: Palpation reveals no lymphadenopathy, swelling, or tenderness. No nuchal rigidity

    **Respiration:** exhibits normal structure without evidence of curvature or protrusions. Respiration is regular at a rate of 20 bpm. Lungs are clear bilaterally.

    **CV:** Rhythm is regular. No heart murmur was appreciated.

    **Neuro:** Reflexes are present and symmetric. Cranial Nerves: No sign of apparent neurological deficit.

    **Developmental milestones**: Industry and inferiority. Z.O. is becoming more independent. Feeling confident with accomplishments in school.

    **Differential diagnosis**

    **DD#1:** Allergic Conjunctivitis.
    _Pathophysiology_: The conjunctiva is a delicate mucous membrane that can become inflamed or infected from a bacterial or viral infection, allergen, chemical agent, or physical irritant. The infection or irritation can cause dilation of the conjunctival vessels, which leads to the classic red eye and edema of the conjunctiva. The symptoms of conjunctivitis can affect one or both eyes depending on the causative agent. Other symptoms include a scratching or burning sensation, photophobia, discharge, or exudate. The discharge can be purulent or watery depending on the cause (Brady et al., 2020).
    _Positive_: Conjunctivitis can affect only one eye. Mum reports erythema and mild edema to the right eye only.
    _Negatives_: Clinical exam reveals no erythema and crusting or yellow discharge. Mum denies visual changes like photophobia.

    **DD#2:** Preseptal cellulitis Pathophysiology: Preseptal cellulitis reflects an infection anterior to the orbital septum and does not involve the orbit or other eye structures. The common bacterial cause is streptococcal organisms and staphylococcus aureus. It can also be associated with trauma, foreign bodies, infected lacerations, insect bites, or impetigo, where the infection spreads through the lymphatic channels (Brady et al., 2020).
    _Positive_: Preseptal cellulitis is confined to the soft tissues anterior to the orbital septum—no evidence of orbital involvement found on clinical exam.
    _Negative_: Pt denies trauma or injury from a foreign body.

    **DD # 3**: Dacryocystitis.
    _Pathophysiology_: Dacryocystitis is an inflammation of the involved nasolacrimal duct that can lead to infection. It is common in neonates, but it can occur at any age due to trauma to the duct or a chronic duct obstruction from an upper respiratory illness. Also, it is found more frequently in those with craniofacial disorders and Down syndrome (Brady et al., 2020).  Symptoms include tearing, stickiness, tenderness, swelling over the lacrimal duct, blepharitis in lids and lashes.
    _Positive_: swelling of tissues surrounding the eye.

    _Negative_: No purulent discharge, stickiness to lids and lashes, or tearing. Pt denies a history of trauma or URI symptoms—no medical history of craniofacial disorder..

    **Pharmacology intervention**

    · Olopatadine 0.1%: Ophthalmic: Instill one drop in each eye twice daily for eye irritation.

    **Non-pharmacology intervention**

    · Patients should not rub their eyes because rubbing can cause mechanical mast cell degranulation and worsening symptoms.

    · Cool compresses can help reduce eyelid and periorbital edema.

    · Frequent use of refrigerated artificial tears throughout the day can also help dilute and remove allergens.

    · Avoidance or reduction of contact with known allergens and appropriate reduction of environmental exposure

    · Educate on proper hand hygiene

    **Monitor Symptoms**

    · Ensure that the redness and swelling gradually improve over the next few days.

    · If the eye becomes more swollen or painful, or if the child starts developing a fever, these may indicate a more severe condition (e.g., preseptal cellulitis or a secondary infection).

    · If the child complains of blurry vision, light sensitivity (photophobia), or an abnormal pupil, seek medical attention immediately.

    **Follow-Up**

    · As recommended, schedule a follow-up appointment in 3 days to reassess the eye. If the condition does not improve by then or if symptoms change, further evaluation may be necessary to rule out other conditions like preseptal cellulitis or dacryocystitis.

    · If the patient develops a fever, worsens pain, or the redness spreads to the other eye, call your healthcare provider immediately or seek urgent care.

    Reference:

    Burns, C. E., Blosser, C. G., Brady, M. A., Dunn, A. M., Garzon, D. L., & Starr, N. B. (2017).
    _Pediatric primary care_. Elsevier.

    Dupuis, P., Prokopich, C. L., Hynes, A., & Kim, H. (2020). A contemporary look at allergic conjunctivitis.
    _Allergy, Asthma &amp; Clinical Immunology_,
    _16_(1).
    [https://doi.org/10.1186/s13223-020-0403-9](https://doi.org/10.1186/s13223-020-0403-9)

    Feeney, Susan, & Fitzgerald, M. A. (2017).
    _Pediatric Physical Assessment_ (tenth). Fitzegrald Health Education Associates, LLC.

    **## N638CaseStudyGradingRubric_2025.docx**

    NOTE

    S: 10 y/o black female in office for constipation x 4 days, Reports hard stools, straining, and discomfort but denies abdominal pain, vomiting, fever, or blood in stool. No recent dietary changes, no history of chronic constipation. Normal fluid intake but low fiber intake. No recent illness or medication use.

    O: Vitals: BP 104/68 mmHg, Temp 98.4°F, HR 82 bpm, RR 18, General: Well-appearing, no acute distress, Abdomen: Soft, mild distension/tenderness in LLQ, no guarding or rebound

    HEENT/Cardio/Resp: Normal

    **A:** Functional constipation

    P: Increase fluid intake, high-fiber diet (fruits, vegetables, whole grains), Stool softener MiraLAX 17gm x daily, Encourage regular toilet habits, Monitor for worsening of symptoms (persistent pain, blood in stool, weight loss), RTC in 1 week if no improvement

    This is just a sample; don’t use these medications. NOTE:
    **Pharmacology interventions MUST BE IN THIS FORMAT**

    Ciprofloxacin (Cipro) 500 mg tablet orally every 12hrs for seven days

    Acetaminophen 650 mg tablet orally every 4-6 hours as needed.

    Ondansetron (Zofran) 8 mg tablet orally every 12 hours as needed for seven days.

    **APA FORMAT, AND REFERENCES, peer review scholarly resource cited in APA format from 2020-2025 only. (Within the last five years)**

    **Please do not solely use a website as your scholarly reference. It is fine to use it as a supplement, but a journal article or text should be referenced.**

    **Please use North American peer-reviewed journals ONLY.**

    **DO NOT use any European Journal**

    **NUR 638 CLINCIAL CASE STUDY (CCS)-GRADING RUBRIC**

    | | | |
    | — | — | — |
    | | Point Breakdown | Points Earned |
    | **History (25 points total)** | | |
    | Chief Complaint | 2 | |
    | History of Present Illness | 6 | |
    | History: past medical hx, prenatal, medications, allergies, surgeries, vaccines | 6 | |
    | Developmental History | 4 | |
    | Family History, Social History | 2 | |
    | Review Of Systems | 5 | |
    | | | |
    | **Physical Exam (25 points total)** | | |
    | Appropriate Systems Examined (Include VS, growth percentiles) | 8 | |
    | Appropriate exam technique to evaluate problem | 5 | |
    | Age-appropriate developmental exam | 6 | |
    | Accuracy of documentation, appropriate terminology | 6 | |
    | | | |
    | **Assessment: Differential Diagnoses (DD) (25 points total)** | | |
    | Three DD, primary DD listed first | 9 (3 @ 3points each) | |
    | Pathophysiology support primary DD | 4 | |
    | Definition for each DD | 9 (3 @ 3 points each) | |
    | Rationale and pertinent positives/negatives for each DD | 3 | |
    | | | |
    | **Plan of Care (25 points total)** | | |
    | Testing and diagnostic studies | 2 | |
    | Pharmacologic (including prescription, OTC, herbals) ALL in prescriptive format<br>Include dosing calculation parameters for each medication (ex., mg/kg divided bid) | 6 | |
    | Non-Pharmacologic Treatment/Symptomatic Treatment | 4 | |
    | Patient Education | 4 | |
    | Anticipatory Guidance | 5 | |
    | Follow-up (includes symptoms to watch for, when to call office, when to return) | 4 | |
    | | | |
    | Deductions: | | |
    | Grammar, Spelling Errors: -1 point each error | | |
    | Incorrect APA Format: -5 points | | |
    | Incorrect References: -2 points each incorrect or missing references | | |
    | | | |
    | **Total Points** | | |

    **## N638CaseStudyGradingRubric_2025.docx**

    NOTE

    S: 10 y/o black female in office for constipation x 4 days, Reports hard stools, straining, and discomfort but denies abdominal pain, vomiting, fever, or blood in stool. No recent dietary changes, no history of chronic constipation. Normal fluid intake but low fiber intake. No recent illness or medication use.

    O: Vitals: BP 104/68 mmHg, Temp 98.4°F, HR 82 bpm, RR 18, General: Well-appearing, no acute distress, Abdomen: Soft, mild distension/tenderness in LLQ, no guarding or rebound

    HEENT/Cardio/Resp: Normal

    **A:** Functional constipation

    P: Increase fluid intake, high-fiber diet (fruits, vegetables, whole grains), Stool softener MiraLAX 17gm x daily, Encourage regular toilet habits, Monitor for worsening of symptoms (persistent pain, blood in stool, weight loss), RTC in 1 week if no improvement

    This is just a sample; don’t use these medications. NOTE:
    **Pharmacology interventions MUST BE IN THIS FORMAT**

    Ciprofloxacin (Cipro) 500 mg tablet orally every 12hrs for seven days

    Acetaminophen 650 mg tablet orally every 4-6 hours as needed.

    Ondansetron (Zofran) 8 mg tablet orally every 12 hours as needed for seven days.

    **APA FORMAT, AND REFERENCES, peer review scholarly resource cited in APA format from 2020-2025 only. (Within the last five years)**

    **Please do not solely use a website as your scholarly reference. It is fine to use it as a supplement, but a journal article or text should be referenced.**

    **Please use North American peer-reviewed journals ONLY.**

    **DO NOT use any European Journal**

    **NUR 638 CLINCIAL CASE STUDY (CCS)-GRADING RUBRIC**

    | | | |
    | — | — | — |
    | | Point Breakdown | Points Earned |
    | **History (25 points total)** | | |
    | Chief Complaint | 2 | |
    | History of Present Illness | 6 | |
    | History: past medical hx, prenatal, medications, allergies, surgeries, vaccines | 6 | |
    | Developmental History | 4 | |
    | Family History, Social History | 2 | |
    | Review Of Systems | 5 | |
    | | | |
    | **Physical Exam (25 points total)** | | |
    | Appropriate Systems Examined (Include VS, growth percentiles) | 8 | |
    | Appropriate exam technique to evaluate problem | 5 | |
    | Age-appropriate developmental exam | 6 | |
    | Accuracy of documentation, appropriate terminology | 6 | |
    | | | |
    | **Assessment: Differential Diagnoses (DD) (25 points total)** | | |
    | Three DD, primary DD listed first | 9 (3 @ 3points each) | |
    | Pathophysiology support primary DD | 4 | |
    | Definition for each DD | 9 (3 @ 3 points each) | |
    | Rationale and pertinent positives/negatives for each DD | 3 | |
    | | | |
    | **Plan of Care (25 points total)** | | |
    | Testing and diagnostic studies | 2 | |
    | Pharmacologic (including prescription, OTC, herbals) ALL in prescriptive format<br>Include dosing calculation parameters for each medication (ex., mg/kg divided bid) | 6 | |
    | Non-Pharmacologic Treatment/Symptomatic Treatment | 4 | |
    | Patient Education | 4 | |
    | Anticipatory Guidance | 5 | |
    | Follow-up (includes symptoms to watch for, when to call office, when to return) | 4 | |
    | | | |
    | Deductions: | | |
    | Grammar, Spelling Errors: -1 point each error | | |
    | Incorrect APA Format: -5 points | | |
    | Incorrect References: -2 points each incorrect or missing references | | |
    | | | |
    | **Total Points** | | |

    **## CASE_STUDY_GUILD_638.docx**

    **NUR 638 – CASE STUDY FORMAT**

    CC: (6yo male with cough X 1 week)

    HPI – history of present illness. This is subjective data that the patient or parent is telling you about the illness. It is the “story” of why the patient is coming to see you, include anything that is relevant (such as co-morbidities).

    Example: 5yo female with history of asthma brought to the clinic by mother for c/o cough for 5 days, worse at night. Cough sounds barky. Mother also reports the patient is wheezing and short of breath when engaging in activity. Also has a runny nose and sore throat. Had a fever of 102 yesterday but none today. Cough is worse at night. Drinking well, urinating normally. Siblings are also sick.

    PMH – past medical history (include gestation, ie. prematurity and delivery problems if pertinent)

    Surgical history

    Family history

    Medications (name of medication, dose, indication) use prescriptive format

    Immunizations

    Social or Home situation – who do they live with, siblings, pets (pertinent for respiratory or allergy complaints), smoking. For the well visit you would go over the developmental milestones.

    ROS-review of systems: review all of the pertinent body systems (even if you covered it in the HPI). For the well visit, you will need to do a complete ROS.

    Physical exam: complete if a well child, pertinent systems for a specific complaint. However, EVERY patient should have a Respiratory and Cardiovascular assessment. You will include vital signs and the results of any diagnostic testing.

    Include age appropriate developmental assessment, including milestones and stages.

    Differential Diagnoses: What disease do you think is causing the symptoms? List your primary or working diagnosis first. Include 3 differentials with supporting pathology. You can put pertinent positives and negatives to support your diagnosis.

    Plan of Care: Include everything that you will do for this patient. Medications, written in prescriptive format (dose, route, frequency, duration, indication). Any lab work or diagnostic testing that you will order. Non pharmacologic therapies. Patient teaching including things the patient can do to prevent disease transmission, symptoms that you would want the patient to watch for and what to do if they occur. Follow up directions – including a time frame and who/where they should go. Remember for your Well Visit you will need to discuss anticipatory guidance!

    Reference your sources using APA format. Use your advanced practice journal article for pathophysiology or treatment plan information for the diagnosis.

    Follow the grading rubric. Some of these case studies will be long. As always, speak to your assigned faculty if you have any questions.

    **## CaseStudy_Sample_ade.docx**

    7

    **History:**

    CC: 3-year-old. Male with R. Eye Redness x 4 days.

    HPI:Z.O. is a 3-year-old M with no significant PMH who presents to the office for a sick visit—accompanied by his mom. Mom complained of redness in the Right eye for 4 days. Mom reports that the patient started c/o clear drainage, pain in the Right eye 4 days ago and noticed redness 2 days ago accompanied by itching.  She applied warm compresses and has been given cetirizine for 2 days now with no improvement. Mom denies any contact with anyone who has pink eye. Denies yellow drainage, crusting eye, and closing of the eyelid. Denies any cold symptoms. Denies any visual changes or trauma to the eye. The patient has remained afebrile. He has average oral intake and urine output. Pt currently goes to Head Start, but there is no report of any student with pink eye. Z.O. has no active medications or known drug or food allergies.

    **Diet:** He likes to eat Somali food, pizza, rice, and vegetables.

    **Elimination**: He is fully potty trained.

    **Sleep:** Pt Sleep from 10 pm- 7 am

    **Behavior:** Social interaction is age-appropriate. Once the patient becomes familiar with the situation, he will make friends in new places—no concerns from school or parents.

    **Development:** The child paid appropriate attention and was involved in the exam. Developmentally appropriate.

    **Speech:** Child speech is developmentally appropriate, spontaneous, smooth, and articulate. The primary language in the family is English, and the child speaks English.

    **Social hx**: Z.O. lives with his Parent and two sisters. Like to play with his sibling. Also in head start and participate in class with friends. Home is smoke-free and pet-free

    **PMH**: Mom reports full-term birth with no complications. No surgical history. No significant family history. No active medications.

    Immunizations reviewed and up to date.

    **ROS**:

    **General:** Healthy-appearing, well-nourished, and alert child.

    **Skin**: Denies skin, hair, and nail symptoms.

    **HEENT**: No history of head injury.
    _Eyes_: Reports erythema of the R. Eye and mild swelling.
    _Ears_: Hearing good. No tinnitus, vertigo, infections.
    _Nose_: No hay fever or sinus trouble.
    _Throat_: No tooth pain or gum bleeding.

    **Neck**: No lumps, goiter, pain. No swollen glands.

    **Cardiovascular**: No chest pain, palpitations, dyspnea, orthopnea.

    **Respiratory**: No cough, wheezing, shortness of breath.

    **Physical exam**:

    Vitals: T: 98.7 Wt: 33lb 3oz Wt kg: 15.054 Pulse: 105 Resp: 25 O2SatR: 99

    **General:** Healthy appearing child. Well-nourished and alert. Weighs within the normal range. Mucous membranes are moist and pink. Respiratory pattern is unremarkable. No grunting or nasal flaring.

    **Head and face**: The size of the skull is developmentally appropriate and is in proportion to the rest of the body. Facial move symmetrically and are midline. There is no evidence of dropping, asymmetry, or disproportionate features.

    **Eye:** The conjunctivae show clear white discharge, erythema, and mild swelling in the right eye. The pupil is equal, round, and reactive to light and accommodation. The sclera is clear and anicteric. There is no pain with extraocular movement. Left eye: No abnormalities are noted in the left eye; it appears unaffected.

    **Neck**: Palpation reveals no lymphadenopathy, swelling, or tenderness. No nuchal rigidity

    **Respiration:** exhibits normal structure without evidence of curvature or protrusions. Respiration is regular at a rate of 20 bpm. Lungs are clear bilaterally.

    **CV:** Rhythm is regular. No heart murmur was appreciated.

    **Neuro:** Reflexes are present and symmetric. Cranial Nerves: No sign of apparent neurological deficit.

    **Developmental milestones**: Industry and inferiority. Z.O. is becoming more independent. Feeling confident with accomplishments in school.

    **Differential diagnosis**

    **DD#1:** Allergic Conjunctivitis.
    _Pathophysiology_: The conjunctiva is a delicate mucous membrane that can become inflamed or infected from a bacterial or viral infection, allergen, chemical agent, or physical irritant. The infection or irritation can cause dilation of the conjunctival vessels, which leads to the classic red eye and edema of the conjunctiva. The symptoms of conjunctivitis can affect one or both eyes depending on the causative agent. Other symptoms include a scratching or burning sensation, photophobia, discharge, or exudate. The discharge can be purulent or watery depending on the cause (Brady et al., 2020).
    _Positive_: Conjunctivitis can affect only one eye. Mum reports erythema and mild edema to the right eye only.
    _Negatives_: Clinical exam reveals no erythema and crusting or yellow discharge. Mum denies visual changes like photophobia.

    **DD#2:** Preseptal cellulitis Pathophysiology: Preseptal cellulitis reflects an infection anterior to the orbital septum and does not involve the orbit or other eye structures. The common bacterial cause is streptococcal organisms and staphylococcus aureus. It can also be associated with trauma, foreign bodies, infected lacerations, insect bites, or impetigo, where the infection spreads through the lymphatic channels (Brady et al., 2020).
    _Positive_: Preseptal cellulitis is confined to the soft tissues anterior to the orbital septum—no evidence of orbital involvement found on clinical exam.
    _Negative_: Pt denies trauma or injury from a foreign body.

    **DD # 3**: Dacryocystitis.
    _Pathophysiology_: Dacryocystitis is an inflammation of the involved nasolacrimal duct that can lead to infection. It is common in neonates, but it can occur at any age due to trauma to the duct or a chronic duct obstruction from an upper respiratory illness. Also, it is found more frequently in those with craniofacial disorders and Down syndrome (Brady et al., 2020).  Symptoms include tearing, stickiness, tenderness, swelling over the lacrimal duct, blepharitis in lids and lashes.
    _Positive_: swelling of tissues surrounding the eye.

    _Negative_: No purulent discharge, stickiness to lids and lashes, or tearing. Pt denies a history of trauma or URI symptoms—no medical history of craniofacial disorder..

    **Pharmacology intervention**

    · Olopatadine 0.1%: Ophthalmic: Instill one drop in each eye twice daily for eye irritation.

    **Non-pharmacology intervention**

    · Patients should not rub their eyes because rubbing can cause mechanical mast cell degranulation and worsening symptoms.

    · Cool compresses can help reduce eyelid and periorbital edema.

    · Frequent use of refrigerated artificial tears throughout the day can also help dilute and remove allergens.

    · Avoidance or reduction of contact with known allergens and appropriate reduction of environmental exposure

    · Educate on proper hand hygiene

    **Monitor Symptoms**

    · Ensure that the redness and swelling gradually improve over the next few days.

    · If the eye becomes more swollen or painful, or if the child starts developing a fever, these may indicate a more severe condition (e.g., preseptal cellulitis or a secondary infection).

    · If the child complains of blurry vision, light sensitivity (photophobia), or an abnormal pupil, seek medical attention immediately.

    **Follow-Up**

    · As recommended, schedule a follow-up appointment in 3 days to reassess the eye. If the condition does not improve by then or if symptoms change, further evaluation may be necessary to rule out other conditions like preseptal cellulitis or dacryocystitis.

    · If the patient develops a fever, worsens pain, or the redness spreads to the other eye, call your healthcare provider immediately or seek urgent care.

    Reference:

    Burns, C. E., Blosser, C. G., Brady, M. A., Dunn, A. M., Garzon, D. L., & Starr, N. B. (2017).
    _Pediatric primary care_. Elsevier.

    Dupuis, P., Prokopich, C. L., Hynes, A., & Kim, H. (2020). A contemporary look at allergic conjunctivitis.
    _Allergy, Asthma &amp; Clinical Immunology_,
    _16_(1).
    [https://doi.org/10.1186/s13223-020-0403-9](https://doi.org/10.1186/s13223-020-0403-9)

    Feeney, Susan, & Fitzgerald, M. A. (2017).
    _Pediatric Physical Assessment_ (tenth). Fitzegrald Health Education Associates, LLC.

    **## N638CaseStudyGradingRubric_2025.docx**

    NOTE

    S: 10 y/o black female in office for constipation x 4 days, Reports hard stools, straining, and discomfort but denies abdominal pain, vomiting, fever, or blood in stool. No recent dietary changes, no history of chronic constipation. Normal fluid intake but low fiber intake. No recent illness or medication use.

    O: Vitals: BP 104/68 mmHg, Temp 98.4°F, HR 82 bpm, RR 18, General: Well-appearing, no acute distress, Abdomen: Soft, mild distension/tenderness in LLQ, no guarding or rebound

    HEENT/Cardio/Resp: Normal

    **A:** Functional constipation

    P: Increase fluid intake, high-fiber diet (fruits, vegetables, whole grains), Stool softener MiraLAX 17gm x daily, Encourage regular toilet habits, Monitor for worsening of symptoms (persistent pain, blood in stool, weight loss), RTC in 1 week if no improvement

    This is just a sample; don’t use these medications. NOTE:
    **Pharmacology interventions MUST BE IN THIS FORMAT**

    Ciprofloxacin (Cipro) 500 mg tablet orally every 12hrs for seven days

    Acetaminophen 650 mg tablet orally every 4-6 hours as needed.

    Ondansetron (Zofran) 8 mg tablet orally every 12 hours as needed for seven days.

    **APA FORMAT, AND REFERENCES, peer review scholarly resource cited in APA format from 2020-2025 only. (Within the last five years)**

    **Please do not solely use a website as your scholarly reference. It is fine to use it as a supplement, but a journal article or text should be referenced.**

    **Please use North American peer-reviewed journals ONLY.**

    **DO NOT use any European Journal**

    **NUR 638 CLINCIAL CASE STUDY (CCS)-GRADING RUBRIC**

    | | | |
    | — | — | — |
    | | Point Breakdown | Points Earned |
    | **History (25 points total)** | | |
    | Chief Complaint | 2 | |
    | History of Present Illness | 6 | |
    | History: past medical hx, prenatal, medications, allergies, surgeries, vaccines | 6 | |
    | Developmental History | 4 | |
    | Family History, Social History | 2 | |
    | Review Of Systems | 5 | |
    | | | |
    | **Physical Exam (25 points total)** | | |
    | Appropriate Systems Examined (Include VS, growth percentiles) | 8 | |
    | Appropriate exam technique to evaluate problem | 5 | |
    | Age-appropriate developmental exam | 6 | |
    | Accuracy of documentation, appropriate terminology | 6 | |
    | | | |
    | **Assessment: Differential Diagnoses (DD) (25 points total)** | | |
    | Three DD, primary DD listed first | 9 (3 @ 3points each) | |
    | Pathophysiology support primary DD | 4 | |
    | Definition for each DD | 9 (3 @ 3 points each) | |
    | Rationale and pertinent positives/negatives for each DD | 3 | |
    | | | |
    | **Plan of Care (25 points total)** | | |
    | Testing and diagnostic studies | 2 | |
    | Pharmacologic (including prescription, OTC, herbals) ALL in prescriptive format<br>Include dosing calculation parameters for each medication (ex., mg/kg divided bid) | 6 | |
    | Non-Pharmacologic Treatment/Symptomatic Treatment | 4 | |
    | Patient Education | 4 | |
    | Anticipatory Guidance | 5 | |
    | Follow-up (includes symptoms to watch for, when to call office, when to return) | 4 | |
    | | | |
    | Deductions: | | |
    | Grammar, Spelling Errors: -1 point each error | | |
    | Incorrect APA Format: -5 points | | |
    | Incorrect References: -2 points each incorrect or missing references | | |
    | | | |
    | **Total Points** | | |

    **## CASE_STUDY_GUILD_638.docx**

    **NUR 638 – CASE STUDY FORMAT**

    CC: (6yo male with cough X 1 week)

    HPI – history of present illness. This is subjective data that the patient or parent is telling you about the illness. It is the “story” of why the patient is coming to see you, include anything that is relevant (such as co-morbidities).

    Example: 5yo female with history of asthma brought to the clinic by mother for c/o cough for 5 days, worse at night. Cough sounds barky. Mother also reports the patient is wheezing and short of breath when engaging in activity. Also has a runny nose and sore throat. Had a fever of 102 yesterday but none today. Cough is worse at night. Drinking well, urinating normally. Siblings are also sick.

    PMH – past medical history (include gestation, ie. prematurity and delivery problems if pertinent)

    Surgical history

    Family history

    Medications (name of medication, dose, indication) use prescriptive format

    Immunizations

    Social or Home situation – who do they live with, siblings, pets (pertinent for respiratory or allergy complaints), smoking. For the well visit you would go over the developmental milestones.

    ROS-review of systems: review all of the pertinent body systems (even if you covered it in the HPI). For the well visit, you will need to do a complete ROS.

    Physical exam: complete if a well child, pertinent systems for a specific complaint. However, EVERY patient should have a Respiratory and Cardiovascular assessment. You will include vital signs and the results of any diagnostic testing.

    Include age appropriate developmental assessment, including milestones and stages.

    Differential Diagnoses: What disease do you think is causing the symptoms? List your primary or working diagnosis first. Include 3 differentials with supporting pathology. You can put pertinent positives and negatives to support your diagnosis.

    Plan of Care: Include everything that you will do for this patient. Medications, written in prescriptive format (dose, route, frequency, duration, indication). Any lab work or diagnostic testing that you will order. Non pharmacologic therapies. Patient teaching including things the patient can do to prevent disease transmission, symptoms that you would want the patient to watch for and what to do if they occur. Follow up directions – including a time frame and who/where they should go. Remember for your Well Visit you will need to discuss anticipatory guidance!

    Reference your sources using APA format. Use your advanced practice journal article for pathophysiology or treatment plan information for the diagnosis.

    Follow the grading rubric. Some of these case studies will be long. As always, speak to your assigned faculty if you have any questions.

    **## CaseStudy_Sample_ade.docx**

    7

    **History:**

    CC: 3-year-old. Male with R. Eye Redness x 4 days.

    HPI:Z.O. is a 3-year-old M with no significant PMH who presents to the office for a sick visit—accompanied by his mom. Mom complained of redness in the Right eye for 4 days. Mom reports that the patient started c/o clear drainage, pain in the Right eye 4 days ago and noticed redness 2 days ago accompanied by itching.  She applied warm compresses and has been given cetirizine for 2 days now with no improvement. Mom denies any contact with anyone who has pink eye. Denies yellow drainage, crusting eye, and closing of the eyelid. Denies any cold symptoms. Denies any visual changes or trauma to the eye. The patient has remained afebrile. He has average oral intake and urine output. Pt currently goes to Head Start, but there is no report of any student with pink eye. Z.O. has no active medications or known drug or food allergies.

    **Diet:** He likes to eat Somali food, pizza, rice, and vegetables.

    **Elimination**: He is fully potty trained.

    **Sleep:** Pt Sleep from 10 pm- 7 am

    **Behavior:** Social interaction is age-appropriate. Once the patient becomes familiar with the situation, he will make friends in new places—no concerns from school or parents.

    **Development:** The child paid appropriate attention and was involved in the exam. Developmentally appropriate.

    **Speech:** Child speech is developmentally appropriate, spontaneous, smooth, and articulate. The primary language in the family is English, and the child speaks English.

    **Social hx**: Z.O. lives with his Parent and two sisters. Like to play with his sibling. Also in head start and participate in class with friends. Home is smoke-free and pet-free

    **PMH**: Mom reports full-term birth with no complications. No surgical history. No significant family history. No active medications.

    Immunizations reviewed and up to date.

    **ROS**:

    **General:** Healthy-appearing, well-nourished, and alert child.

    **Skin**: Denies skin, hair, and nail symptoms.

    **HEENT**: No history of head injury.
    _Eyes_: Reports erythema of the R. Eye and mild swelling.
    _Ears_: Hearing good. No tinnitus, vertigo, infections.
    _Nose_: No hay fever or sinus trouble.
    _Throat_: No tooth pain or gum bleeding.

    **Neck**: No lumps, goiter, pain. No swollen glands.

    **Cardiovascular**: No chest pain, palpitations, dyspnea, orthopnea.

    **Respiratory**: No cough, wheezing, shortness of breath.

    **Physical exam**:

    Vitals: T: 98.7 Wt: 33lb 3oz Wt kg: 15.054 Pulse: 105 Resp: 25 O2SatR: 99

    **General:** Healthy appearing child. Well-nourished and alert. Weighs within the normal range. Mucous membranes are moist and pink. Respiratory pattern is unremarkable. No grunting or nasal flaring.

    **Head and face**: The size of the skull is developmentally appropriate and is in proportion to the rest of the body. Facial move symmetrically and are midline. There is no evidence of dropping, asymmetry, or disproportionate features.

    **Eye:** The conjunctivae show clear white discharge, erythema, and mild swelling in the right eye. The pupil is equal, round, and reactive to light and accommodation. The sclera is clear and anicteric. There is no pain with extraocular movement. Left eye: No abnormalities are noted in the left eye; it appears unaffected.

    **Neck**: Palpation reveals no lymphadenopathy, swelling, or tenderness. No nuchal rigidity

    **Respiration:** exhibits normal structure without evidence of curvature or protrusions. Respiration is regular at a rate of 20 bpm. Lungs are clear bilaterally.

    **CV:** Rhythm is regular. No heart murmur was appreciated.

    **Neuro:** Reflexes are present and symmetric. Cranial Nerves: No sign of apparent neurological deficit.

    **Developmental milestones**: Industry and inferiority. Z.O. is becoming more independent. Feeling confident with accomplishments in school.

    **Differential diagnosis**

    **DD#1:** Allergic Conjunctivitis.
    _Pathophysiology_: The conjunctiva is a delicate mucous membrane that can become inflamed or infected from a bacterial or viral infection, allergen, chemical agent, or physical irritant. The infection or irritation can cause dilation of the conjunctival vessels, which leads to the classic red eye and edema of the conjunctiva. The symptoms of conjunctivitis can affect one or both eyes depending on the causative agent. Other symptoms include a scratching or burning sensation, photophobia, discharge, or exudate. The discharge can be purulent or watery depending on the cause (Brady et al., 2020).
    _Positive_: Conjunctivitis can affect only one eye. Mum reports erythema and mild edema to the right eye only.
    _Negatives_: Clinical exam reveals no erythema and crusting or yellow discharge. Mum denies visual changes like photophobia.

    **DD#2:** Preseptal cellulitis Pathophysiology: Preseptal cellulitis reflects an infection anterior to the orbital septum and does not involve the orbit or other eye structures. The common bacterial cause is streptococcal organisms and staphylococcus aureus. It can also be associated with trauma, foreign bodies, infected lacerations, insect bites, or impetigo, where the infection spreads through the lymphatic channels (Brady et al., 2020).
    _Positive_: Preseptal cellulitis is confined to the soft tissues anterior to the orbital septum—no evidence of orbital involvement found on clinical exam.
    _Negative_: Pt denies trauma or injury from a foreign body.

    **DD # 3**: Dacryocystitis.
    _Pathophysiology_: Dacryocystitis is an inflammation of the involved nasolacrimal duct that can lead to infection. It is common in neonates, but it can occur at any age due to trauma to the duct or a chronic duct obstruction from an upper respiratory illness. Also, it is found more frequently in those with craniofacial disorders and Down syndrome (Brady et al., 2020).  Symptoms include tearing, stickiness, tenderness, swelling over the lacrimal duct, blepharitis in lids and lashes.
    _Positive_: swelling of tissues surrounding the eye.

    _Negative_: No purulent discharge, stickiness to lids and lashes, or tearing. Pt denies a history of trauma or URI symptoms—no medical history of craniofacial disorder..

    **Pharmacology intervention**

    · Olopatadine 0.1%: Ophthalmic: Instill one drop in each eye twice daily for eye irritation.

    **Non-pharmacology intervention**

    · Patients should not rub their eyes because rubbing can cause mechanical mast cell degranulation and worsening symptoms.

    · Cool compresses can help reduce eyelid and periorbital edema.

    · Frequent use of refrigerated artificial tears throughout the day can also help dilute and remove allergens.

    · Avoidance or reduction of contact with known allergens and appropriate reduction of environmental exposure

    · Educate on proper hand hygiene

    **Monitor Symptoms**

    · Ensure that the redness and swelling gradually improve over the next few days.

    · If the eye becomes more swollen or painful, or if the child starts developing a fever, these may indicate a more severe condition (e.g., preseptal cellulitis or a secondary infection).

    · If the child complains of blurry vision, light sensitivity (photophobia), or an abnormal pupil, seek medical attention immediately.

    **Follow-Up**

    · As recommended, schedule a follow-up appointment in 3 days to reassess the eye. If the condition does not improve by then or if symptoms change, further evaluation may be necessary to rule out other conditions like preseptal cellulitis or dacryocystitis.

    · If the patient develops a fever, worsens pain, or the redness spreads to the other eye, call your healthcare provider immediately or seek urgent care.

    Reference:

    Burns, C. E., Blosser, C. G., Brady, M. A., Dunn, A. M., Garzon, D. L., & Starr, N. B. (2017).
    _Pediatric primary care_. Elsevier.

    Dupuis, P., Prokopich, C. L., Hynes, A., & Kim, H. (2020). A contemporary look at allergic conjunctivitis.
    _Allergy, Asthma &amp; Clinical Immunology_,
    _16_(1).
    [https://doi.org/10.1186/s13223-020-0403-9](https://doi.org/10.1186/s13223-020-0403-9)

    Feeney, Susan, & Fitzgerald, M. A. (2017).
    _Pediatric Physical Assessment_ (tenth). Fitzegrald Health Education Associates, LLC.

    **## N638CaseStudyGradingRubric_2025.docx**

    NOTE

    S: 10 y/o black female in office for constipation x 4 days, Reports hard stools, straining, and discomfort but denies abdominal pain, vomiting, fever, or blood in stool. No recent dietary changes, no history of chronic constipation. Normal fluid intake but low fiber intake. No recent illness or medication use.

    O: Vitals: BP 104/68 mmHg, Temp 98.4°F, HR 82 bpm, RR 18, General: Well-appearing, no acute distress, Abdomen: Soft, mild distension/tenderness in LLQ, no guarding or rebound

    HEENT/Cardio/Resp: Normal

    **A:** Functional constipation

    P: Increase fluid intake, high-fiber diet (fruits, vegetables, whole grains), Stool softener MiraLAX 17gm x daily, Encourage regular toilet habits, Monitor for worsening of symptoms (persistent pain, blood in stool, weight loss), RTC in 1 week if no improvement

    This is just a sample; don’t use these medications. NOTE:
    **Pharmacology interventions MUST BE IN THIS FORMAT**

    Ciprofloxacin (Cipro) 500 mg tablet orally every 12hrs for seven days

    Acetaminophen 650 mg tablet orally every 4-6 hours as needed.

    Ondansetron (Zofran) 8 mg tablet orally every 12 hours as needed for seven days.

    **APA FORMAT, AND REFERENCES, peer review scholarly resource cited in APA format from 2020-2025 only. (Within the last five years)**

    **Please do not solely use a website as your scholarly reference. It is fine to use it as a supplement, but a journal article or text should be referenced.**

    **Please use North American peer-reviewed journals ONLY.**

    **DO NOT use any European Journal**

    **NUR 638 CLINCIAL CASE STUDY (CCS)-GRADING RUBRIC**

    | | | |
    | — | — | — |
    | | Point Breakdown | Points Earned |
    | **History (25 points total)** | | |
    | Chief Complaint | 2 | |
    | History of Present Illness | 6 | |
    | History: past medical hx, prenatal, medications, allergies, surgeries, vaccines | 6 | |
    | Developmental History | 4 | |
    | Family History, Social History | 2 | |
    | Review Of Systems | 5 | |
    | | | |
    | **Physical Exam (25 points total)** | | |
    | Appropriate Systems Examined (Include VS, growth percentiles) | 8 | |
    | Appropriate exam technique to evaluate problem | 5 | |
    | Age-appropriate developmental exam | 6 | |
    | Accuracy of documentation, appropriate terminology | 6 | |
    | | | |
    | **Assessment: Differential Diagnoses (DD) (25 points total)** | | |
    | Three DD, primary DD listed first | 9 (3 @ 3points each) | |
    | Pathophysiology support primary DD | 4 | |
    | Definition for each DD | 9 (3 @ 3 points each) | |
    | Rationale and pertinent positives/negatives for each DD | 3 | |
    | | | |
    | **Plan of Care (25 points total)** | | |
    | Testing and diagnostic studies | 2 | |
    | Pharmacologic (including prescription, OTC, herbals) ALL in prescriptive format<br>Include dosing calculation parameters for each medication (ex., mg/kg divided bid) | 6 | |
    | Non-Pharmacologic Treatment/Symptomatic Treatment | 4 | |
    | Patient Education | 4 | |
    | Anticipatory Guidance | 5 | |
    | Follow-up (includes symptoms to watch for, when to call office, when to return) | 4 | |
    | | | |
    | Deductions: | | |
    | Grammar, Spelling Errors: -1 point each error | | |
    | Incorrect APA Format: -5 points | | |
    | Incorrect References: -2 points each incorrect or missing references | | |
    | | | |
    | **Total Points** | | |

  • [Solved] For your worst training experience, what elements of BST were missing? What did they do that made you dislike the training?

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    Describe either your best training experience, OR your worst training experience. For your best training experience, what elements of BST were included? What did they do that made you enjoy the training? For your worst training experience, what elements of BST were missing? What did they do that mad…

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    Assignment Prompt & Instructions

    Describe either your best training experience, OR your worst training experience.

    For your best training experience, what elements of BST were included? What did they do that made you enjoy the training?

    For your worst training experience, what elements of BST were missing? What did they do that made you dislike the training?

    In either case, to your knowledge, did they collect any measures to evaluate the quality of training? If so, what did they evaluate?

    – 2 years ago

  • [Solved] Business Finance – Management Assignment pro

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    [>Management homework help](https://www.sweetstudy.com/fields/business-finance-management) The assignment requires you to identify a current change in an organization with which you are familiar, and evaluate a current public issue about which “something must be done.” About the change issue, think …

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    [>Management homework help](https://www.sweetstudy.com/fields/business-finance-management)

    The assignment requires you to identify a current change in an organization with which you are familiar, and evaluate a current public issue about which “something must be done.” About the change issue, think about what sense-making changes might need to be enacted and how you would do this. Then, design a mindmap visually assessing this in terms of the 8 elements of the sense-making framework suggested by Helms Mills and as set out in Table 9.7 which is in Chapter 9 of the Managing Organizational Change: A Multiple Perspectives Approach textbook

    Make sure you address the following questions visually in the mind map:

    – Which ones did you believe you might have the most/least control over, and why?
    – What implications does this have for adopting a sense-making approach to organizational change?

    – [\
    \
    Assignmentpro.docx](https://www.sweetstudy.com/files/assignmentpro-docx "Assignmentpro.docx")

    – 2 years ago

  • [Solved] Ethical Values of Therapists and Code of Ethics

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    **Ethical Values of Therapists and Code of Ethics** – 2 years ago

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    **Ethical Values of Therapists and Code of Ethics**

    – 2 years ago

  • [Solved] English Epigenetics and Stress Assignment

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    All Instructions Below: – 2 years ago **files (1)** – ## PaperAssignmentNoMindtap.pdf **## PaperAssignmentNoMindtap.pdf** The assignment requires a 1,000-word paper on the impact of epigenetics and stress, ensuring 90% originality (excluding references). Students must complete multiple tasks, includ…

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    All Instructions Below:

    – 2 years ago

    **files (1)**

    – ## PaperAssignmentNoMindtap.pdf

    **## PaperAssignmentNoMindtap.pdf**

    The assignment requires a 1,000-word paper on the impact of epigenetics and stress,

    ensuring 90% originality (excluding references). Students must complete multiple tasks,

    including watching Robert Sapolsky’s video on stress, completing surveys, interviewing family

    members about stress-related diseases, and researching an academic article on stress and a

    related disease. The paper should be structured into several key sections:

    1. Definition of Stress & Video Reaction

    ○ Define stress in your own words.

    ○ Discuss key insights from Sapolsky’s video, emphasizing the difference between

    acute vs. chronic stress, the role of stress hormones (cortisol, adrenaline), the

    impact of social support, and the importance of perceived control in reducing

    stress-related harm.

    2. Life Experiences & Family History

    ○ Reflect on personal stressful experiences from the last two years.

    ○ Interview family members to determine stress-related diseases that you may be at

    risk for.

    ○ Reference the WebMD article on 10 stress-related diseases, which include heart

    disease, diabetes, depression, and Alzheimer's.

    3. Research on Stress and Health

    ○ Find one academic article (from a journal or government publication) on stress

    and a related disease you may be at risk for.

    ○ Summarize and paraphrase key findings while using APA citations.

    4. Discussion on Stress and Modern Life

    ○ Discuss how modern lifestyles contribute to stress.

    ○ Examine self-created stressors and ways to minimize them.

    ○ Suggest societal changes to reduce stress and explore strategies for maintaining

    balance in life.

    5. Health & Longevity Reflection

    ○ Based on your research, discuss how to improve your health and reduce stress

    risks.

    ○ Connect findings to personal and family history and suggest ways to manage

    stress effectively through exercise, meditation, and lifestyle adjustments.

    Key Guidelines

    ● Use APA format for citations.

    ● The stress research article must be from a reputable academic source (not Wikipedia,

    magazines, or general websites).

    ● Maintain at least 90% originality with a plagiarism score below 10%.

    ● Follow structured sections, ensuring a logical flow of ideas and analysis.

    This assignment integrates scientific research, personal reflection, and stress management

    strategies to enhance understanding of how epigenetics and stress influence health and longevity.

    In his video on stress, Robert Sapolsky, a Stanford biologist, explains that while a short-term

    stress response is beneficial for survival in acute situations, chronic stress can have severe

    negative impacts on health due to its effects on the body's hormonal system, particularly when

    the stress response is constantly activated without proper recovery time; he emphasizes the

    importance of social connection and a sense of control to mitigate stress, often drawing on his

    research with baboons to illustrate these points; he also discusses how stress can interact with

    genetics and early life experiences to influence our stress response later in life.

    Key points about Sapolsky's stress perspective:

    Acute vs. Chronic Stress:

    The key distinction is between a short-term, beneficial stress response (like fleeing from

    danger) and prolonged, chronic stress (like constant work pressure) which can lead to

    health problems.

    Stress Hormones:

    When stressed, the body releases hormones like cortisol and adrenaline, which can be

    helpful in the short term but become detrimental with chronic stress.

    Social Support:

    Strong social bonds and positive social interactions can act as a buffer against stress and

    improve overall well-being.

    Baboons as a Model:

    Sapolsky's research on baboon social hierarchies provides insights into how social factors

    influence stress levels in primates, which can be applied to humans.

    Perceived Control:

    Feeling like you have some control over a stressful situation can significantly reduce its

    negative impact.

    Impact on Health:

    Chronic stress is linked to a range of health issues including cardiovascular disease,

    weakened immune system, and mental health problems.

    – The assignment requires a 1,000-word paper on the impact of epigenetics and stress, ensuring 90% originality (excluding references). Students must complete multiple tasks, including watching Robert Sapolsky’s video on stress, completing surveys, interviewing family members about stress-related diseases, and researching an academic article on stress and a related disease. The paper should be structured into several key sections:
    – 1.​Definition of Stress & Video Reaction
    – ○​Define stress in your own words.
    – ○​Discuss key insights from Sapolsky’s video, emphasizing the difference between acute vs. chronic stress, the role of stress hormones (cortisol, adrenaline), the impact of social support, and the importance of perceived control in reducing stress-related harm.
    – 2.​Life Experiences & Family History
    – ○​Reflect on personal stressful experiences from the last two years.
    – ○​Interview family members to determine stress-related diseases that you may be at risk for.
    – ○​Reference the WebMD article on 10 stress-related diseases, which include heart disease, diabetes, depression, and Alzheimer's.
    – 3.​Research on Stress and Health
    – ○​Find one academic article (from a journal or government publication) on stress and a related disease you may be at risk for.
    – ○​Summarize and paraphrase key findings while using APA citations.
    – 4.​Discussion on Stress and Modern Life
    – ○​Discuss how modern lifestyles contribute to stress.
    – ○​Examine self-created stressors and ways to minimize them.
    – ○​Suggest societal changes to reduce stress and explore strategies for maintaining balance in life.
    – 5.​Health & Longevity Reflection
    – ○​Based on your research, discuss how to improve your health and reduce stress risks.
    – ○​Connect findings to personal and family history and suggest ways to manage stress effectively through exercise, meditation, and lifestyle adjustments.
    – Key Guidelines
    – ●​Use APA format for citations.
    – ●​The stress research article must be from a reputable academic source (not Wikipedia, magazines, or general websites).
    – ●​Maintain at least 90% originality with a plagiarism score below 10%.
    – ●​Follow structured sections, ensuring a logical flow of ideas and analysis.
    – This assignment integrates scientific research, personal reflection, and stress management strategies to enhance understanding of how epigenetics and stress influence health and longevity.
    – In his video on stress, Robert Sapolsky, a Stanford biologist, explains that while a short-term stress response is beneficial for survival in acute situations, chronic stress can have severe negative impacts on health due to its effects on the body's hormonal system, particularly when the stress response is constantly activated without proper recovery time; he emphasizes the importance of social connection and a sense of control to mitigate stress, often drawing on his research with baboons to illustrate these points; he also discusses how stress can interact with genetics and early life experiences to influence our stress response later in life.
    – Key points about Sapolsky's stress perspective:
    – Acute vs. Chronic Stress:
    – The key distinction is between a short-term, beneficial stress response (like fleeing from danger) and prolonged, chronic stress (like constant work pressure) which can lead to health problems.
    – Stress Hormones:
    – When stressed, the body releases hormones like cortisol and adrenaline, which can be helpful in the short term but become detrimental with chronic stress.
    – Social Support:
    – Strong social bonds and positive social interactions can act as a buffer against stress and improve overall well-being.
    – Baboons as a Model:
    – Sapolsky's research on baboon social hierarchies provides insights into how social factors influence stress levels in primates, which can be applied to humans.
    – Perceived Control:
    – Feeling like you have some control over a stressful situation can significantly reduce its negative impact.
    – Impact on Health:
    – Chronic stress is linked to a range of health issues including cardiovascular disease, weakened immune system, and mental health problems.

    **## PaperAssignmentNoMindtap.pdf**

    The assignment requires a 1,000-word paper on the impact of epigenetics and stress,

    ensuring 90% originality (excluding references). Students must complete multiple tasks,

    including watching Robert Sapolsky’s video on stress, completing surveys, interviewing family

    members about stress-related diseases, and researching an academic article on stress and a

    related disease. The paper should be structured into several key sections:

    1. Definition of Stress & Video Reaction

    ○ Define stress in your own words.

    ○ Discuss key insights from Sapolsky’s video, emphasizing the difference between

    acute vs. chronic stress, the role of stress hormones (cortisol, adrenaline), the

    impact of social support, and the importance of perceived control in reducing

    stress-related harm.

    2. Life Experiences & Family History

    ○ Reflect on personal stressful experiences from the last two years.

    ○ Interview family members to determine stress-related diseases that you may be at

    risk for.

    ○ Reference the WebMD article on 10 stress-related diseases, which include heart

    disease, diabetes, depression, and Alzheimer's.

    3. Research on Stress and Health

    ○ Find one academic article (from a journal or government publication) on stress

    and a related disease you may be at risk for.

    ○ Summarize and paraphrase key findings while using APA citations.

    4. Discussion on Stress and Modern Life

    ○ Discuss how modern lifestyles contribute to stress.

    ○ Examine self-created stressors and ways to minimize them.

    ○ Suggest societal changes to reduce stress and explore strategies for maintaining

    balance in life.

    5. Health & Longevity Reflection

    ○ Based on your research, discuss how to improve your health and reduce stress

    risks.

    ○ Connect findings to personal and family history and suggest ways to manage

    stress effectively through exercise, meditation, and lifestyle adjustments.

    Key Guidelines

    ● Use APA format for citations.

    ● The stress research article must be from a reputable academic source (not Wikipedia,

    magazines, or general websites).

    ● Maintain at least 90% originality with a plagiarism score below 10%.

    ● Follow structured sections, ensuring a logical flow of ideas and analysis.

    This assignment integrates scientific research, personal reflection, and stress management

    strategies to enhance understanding of how epigenetics and stress influence health and longevity.

    In his video on stress, Robert Sapolsky, a Stanford biologist, explains that while a short-term

    stress response is beneficial for survival in acute situations, chronic stress can have severe

    negative impacts on health due to its effects on the body's hormonal system, particularly when

    the stress response is constantly activated without proper recovery time; he emphasizes the

    importance of social connection and a sense of control to mitigate stress, often drawing on his

    research with baboons to illustrate these points; he also discusses how stress can interact with

    genetics and early life experiences to influence our stress response later in life.

    Key points about Sapolsky's stress perspective:

    Acute vs. Chronic Stress:

    The key distinction is between a short-term, beneficial stress response (like fleeing from

    danger) and prolonged, chronic stress (like constant work pressure) which can lead to

    health problems.

    Stress Hormones:

    When stressed, the body releases hormones like cortisol and adrenaline, which can be

    helpful in the short term but become detrimental with chronic stress.

    Social Support:

    Strong social bonds and positive social interactions can act as a buffer against stress and

    improve overall well-being.

    Baboons as a Model:

    Sapolsky's research on baboon social hierarchies provides insights into how social factors

    influence stress levels in primates, which can be applied to humans.

    Perceived Control:

    Feeling like you have some control over a stressful situation can significantly reduce its

    negative impact.

    Impact on Health:

    Chronic stress is linked to a range of health issues including cardiovascular disease,

    weakened immune system, and mental health problems.

    – The assignment requires a 1,000-word paper on the impact of epigenetics and stress, ensuring 90% originality (excluding references). Students must complete multiple tasks, including watching Robert Sapolsky’s video on stress, completing surveys, interviewing family members about stress-related diseases, and researching an academic article on stress and a related disease. The paper should be structured into several key sections:
    – 1.​Definition of Stress & Video Reaction
    – ○​Define stress in your own words.
    – ○​Discuss key insights from Sapolsky’s video, emphasizing the difference between acute vs. chronic stress, the role of stress hormones (cortisol, adrenaline), the impact of social support, and the importance of perceived control in reducing stress-related harm.
    – 2.​Life Experiences & Family History
    – ○​Reflect on personal stressful experiences from the last two years.
    – ○​Interview family members to determine stress-related diseases that you may be at risk for.
    – ○​Reference the WebMD article on 10 stress-related diseases, which include heart disease, diabetes, depression, and Alzheimer's.
    – 3.​Research on Stress and Health
    – ○​Find one academic article (from a journal or government publication) on stress and a related disease you may be at risk for.
    – ○​Summarize and paraphrase key findings while using APA citations.
    – 4.​Discussion on Stress and Modern Life
    – ○​Discuss how modern lifestyles contribute to stress.
    – ○​Examine self-created stressors and ways to minimize them.
    – ○​Suggest societal changes to reduce stress and explore strategies for maintaining balance in life.
    – 5.​Health & Longevity Reflection
    – ○​Based on your research, discuss how to improve your health and reduce stress risks.
    – ○​Connect findings to personal and family history and suggest ways to manage stress effectively through exercise, meditation, and lifestyle adjustments.
    – Key Guidelines
    – ●​Use APA format for citations.
    – ●​The stress research article must be from a reputable academic source (not Wikipedia, magazines, or general websites).
    – ●​Maintain at least 90% originality with a plagiarism score below 10%.
    – ●​Follow structured sections, ensuring a logical flow of ideas and analysis.
    – This assignment integrates scientific research, personal reflection, and stress management strategies to enhance understanding of how epigenetics and stress influence health and longevity.
    – In his video on stress, Robert Sapolsky, a Stanford biologist, explains that while a short-term stress response is beneficial for survival in acute situations, chronic stress can have severe negative impacts on health due to its effects on the body's hormonal system, particularly when the stress response is constantly activated without proper recovery time; he emphasizes the importance of social connection and a sense of control to mitigate stress, often drawing on his research with baboons to illustrate these points; he also discusses how stress can interact with genetics and early life experiences to influence our stress response later in life.
    – Key points about Sapolsky's stress perspective:
    – Acute vs. Chronic Stress:
    – The key distinction is between a short-term, beneficial stress response (like fleeing from danger) and prolonged, chronic stress (like constant work pressure) which can lead to health problems.
    – Stress Hormones:
    – When stressed, the body releases hormones like cortisol and adrenaline, which can be helpful in the short term but become detrimental with chronic stress.
    – Social Support:
    – Strong social bonds and positive social interactions can act as a buffer against stress and improve overall well-being.
    – Baboons as a Model:
    – Sapolsky's research on baboon social hierarchies provides insights into how social factors influence stress levels in primates, which can be applied to humans.
    – Perceived Control:
    – Feeling like you have some control over a stressful situation can significantly reduce its negative impact.
    – Impact on Health:
    – Chronic stress is linked to a range of health issues including cardiovascular disease, weakened immune system, and mental health problems.

  • [Solved] Education EDU530 Week 5 assignment

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    See attached no plagiarism or AI need originality quality work week 5 attached – 2 years ago **files (6)** – ## week5assignment.docx – ## Week2Assignment-v1.docx – ## Week3Assignment-v1.docx – ## Week4Assignment-v1.docx – Chptr1.pdf – Chptr2.pdf **## week5assignment.docx** ![null](https://www.sweets…

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    Assignment Prompt & Instructions

    See attached no plagiarism or AI need originality quality work week 5 attached

    – 2 years ago

    **files (6)**

    – ## week5assignment.docx

    – ## Week2Assignment-v1.docx

    – ## Week3Assignment-v1.docx

    – ## Week4Assignment-v1.docx

    – Chptr1.pdf
    – Chptr2.pdf

    **## week5assignment.docx**

    ![null](https://www.sweetstudy.com/questions/education-edu530-week-5-assignment)

    ![icon](https://www.sweetstudy.com/questions/education-edu530-week-5-assignment)**_Findings and Implications of Your Discovery_**

    **Directions:**

    In this assignment, you will summarize the key findings from your research and discuss the implications of these findings. This part is crucial for highlighting what you have learned through your investigation and how these insights can be applied in a broader context.

    Follow the steps below to effectively present your findings and their implications.

    **Summarize Key Findings:**

    · Begin by clearly outlining the main discoveries or results of your research.

    · Present your findings in a logical order, using bullet points or subheadings if necessary to enhance clarity.

    · Ensure that you include quantitative data (if applicable), qualitative insights, and key themes that emerged from your analysis.

    **Interpret Your Findings:**

    · Provide your interpretation of what these findings mean in relation to your research question or topic.

    · Discuss any surprising results or trends that you observed and why they are significant.

    · Reference any relevant theories, concepts, or frameworks that can help contextualize your findings.

    **Discuss Implications:**

    · Explore the broader implications of your findings for your field of study, industry, or society as a whole.

    · Consider the practical applications of your discoveries. How might they inform policy, practice, or further research?

    · Address any potential limitations or challenges in applying your findings, as well as suggestions for overcoming them.

    **Suggest Future Research Directions:**

    · Based on your findings, propose areas for future research or questions that remain unanswered.

    · Highlight how further investigation could build on your work or contribute to a deeper understanding of the topic.

    **Organize Your Section:**

    · Use clear headings and subheadings to differentiate between findings and implications.

    · Ensure that your writing is concise and focused, providing enough detail to convey your points effectively.

    Combine all the components into a whole and submit your completed research paper.

    **Submission Instructions:**

    · The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.

    · The paper should be formatted per current APA and 10-15 pages in length, excluding the title, abstract and references page. Incorporate a minimum of 6-8 current (published within the last five years) scholarly journal articles within your work.

    · This assignment will be assessed through Turnitin.

    ## image1.png

    ## image2.png

    **## Week2Assignment-v1.docx**

    Running head: DIGITAL TOOL IN EDUCATION AND FORMATIVE ASSESSMENT 2

    DIGITAL TOOLS IN EDUCATION AND FORMATIVE ASSESSMENT 2

    **Digital Tools in Education and Formative Assessment**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    January 26, 2025

    Digital Tools in Education and Formative Assessment

    **Step 1: Topic Exploration**

    Chosen Topic: Digital Tools in Education and Formative Assessment

    **Research Summary:**
    Digital tools included in education and formative assessment are the go-to in education. The three findings from the peer-reviewed research disclose the following:

    1.
    **Challenges in Teachers' Adoption:** Borte et al. (2023) highlight that incongruence in the realm of technology versus pedagogy prevents teachers from taking advantage of the full potential inherent in digital tools-stimulating student-centered learning or even formative assessment practices definition and more teacher training in data literacy.

    2.
    **Evidence of Effectiveness:** According to Sortwell et al. (2024), formative assessment practices positively influence the learning process for students in K-12 if done appropriately. However, more research is needed, given the low certainty of evidence concerning optimal strategies.

    3.
    **Personalized Learning:** Weigand, Trgalova, and Tabach (2024) have discussed how digital tools, especially adaptive systems, allow individualized learning experiences and formative assessments in mathematics education. These tools provide real-time feedback that helps students and teachers address specific learning needs.

    4.
    **Gaps in Current Research**
    **_:_** All three note that digital formative assessment strategies' effectiveness and long-term impact on students' engagement and outcomes remain under-researched.

    5.
    **Challenges for Teachers:** Some challenges that hold back teachers are the limitations of the technology itself, the lack of training to use these technologies, and the lack of research on best practices for using these technologies within formative assessment.

    **Step 2: Narrow Focus**

    **Narrowed Topic:**

    The potential of Artificial Intelligence (AI) ventures to realize an impact on enhancing formative assessment through personalized feedback and specific challenges in teachers' implementation of ventures.

    **Relevance to Assessment and Measurement:**

    This topic is relevant because formative assessment is a cornerstone of effective teaching and learning. Other challenges include equity, teacher autonomy, and professional development when integrating AI. It can lead to insightful ways to design practical AI-driven formative assessment tools and further knowledge of the broader implications for K-12 education.

    **Step 3: Crafting the Guiding Question**

    **Guiding Research Question:**

    How could AI-embedded formative assessment improve personal feedback and decision-making in K-12 education, and what does that indicate for the workload and burden of teachers?

    **Rationale:**

    The guiding question cuts into what is critical and timely: technology and education must work at a crossroads that transform AI possibilities within formative assessment. Therefore, it is because AI provides unlimited ways of constructing productive personalized feedback that can eventually be useful to teachers and educators in providing teaching strategies that can accommodate needs that will be different for different learners; it promises improved results in better learning. For example, it would not be easy to get data education for those teachers by using new technologies and weighing those tools with professional judgment. However, there is an entire issue of equity, access, and ethical issues regarding the use of AI in many K-12 settings. In keeping with the ongoing debate about new inventions in measurement and assessment, there seems to be some search for possibilities in harmony with restrictions about the prospect and usage of formative assessments via AI. For these reasons, such research allows for actual development in ways that will help make any final equitable, vigorous AI-supported assessments feed into teachers and eventually improve the quality of teaching and learning for a regiment of students across all contexts. Additionally, frameworks like the Learning-with-PA Model highlight the importance of contextual factors and digital agents in mediating learning outcomes (Dolata et al., 2023).

    **References**

    Børte, K., Lillejord, S., Chan, J., Lillehaug, B. W., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _100568 ; Educational Research Review ; 41_.
    [https://doi.org/10.1016/j.edurev.2023.100568](https://doi.org/10.1016/j.edurev.2023.100568)

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Carter-Thuiller, B., Gkintoni, E., & Xuan, Q. (2024). A Systematic Review of Meta-Analyses on the Impact of Formative Assessment on K-12 Students’ Learning: Toward Sustainable Quality Education.
    _Sustainability_,
    _16_(17), NA. https://doi.org/10.3390/su16177826

    Weigand, H.-G., Trgalova, J., & Tabach, M. (2024). Mathematics teaching, learning, and assessment in the digital age.
    _ZDM_,
    _56_. https://doi.org/10.1007/s11858-024-01612-9

    **## Week3Assignment-v1.docx**

    Running head: THE BASED OF PREDICTIONS & RATIONALE 2

    THE BASE OF PREDICTIONS & RATIONAL 2

    **The Base of Predictions & Rationale**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    February 2, 2025

    **The Base of Predictions & Rational**

    The growing use of digital technologies in education informs my understanding of AI's potential in formative assessment. AI is used in educational technology to deliver real-time feedback, tailor learning, and help instructors. According to my coursework and readings, formative evaluation allows instructors to detect knowledge gaps, measure progress, and alter teaching (Sortwell et al., 2024). However, AI's ability to improve formative assessment faces severe practical difficulties. Many instructors have challenges using AI-driven formative assessment systems because of insufficient training, equity issues, and technical limits (Børte et al., 2023). AI can create individualized feedback on a scale, but its quality and trustworthiness compared to human review are disputed.

    One of my primary assumptions is that AI-embedded formative assessment will enhance K-12 individualized feedback and decision-making. Previous research has shown that AI can assess student replies, discover trends, and customize feedback to specific learning requirements (Weigand et al., 2024). AI-driven assessment systems might save instructors from grading and assessing student work, letting them concentrate on teaching and student engagement. However, AI may depersonalize education and reduce instructors' participation in formative evaluation. I assume that AI models are bias-free, yet research reveals that many AI systems inherit biases from their training data, which might lead to inequitable evaluation results (Dolata et al., 2023). Identifying bias in AI models raises questions about how AI-generated feedback can affect diverse student groups, especially underprivileged ones.

    The prediction is that AI-embedded formative assessment systems will reduce teacher effort as they improve. Formative assessment is time-consuming. Therefore, AI's capacity to automate processes like grading multiple-choice questions, delivering quick feedback, and creating progress reports should help instructors save time. However, instructors must still analyze AI-generated insights and ensure that feedback meets students' requirements. Higher-order thinking abilities like critical analysis and creativity are frequently best assessed via open-ended replies and classroom discussions. AI may not be able to do so. While AI has shown potential in essay scoring and natural language processing, its capacity to deliver nuanced feedback on complicated student work needs additional study (Sortwell et al., 2024). AI will complement teacher-driven formative evaluation, not replace it.

    One of my uncertainties regarding AI-embedded formative evaluation is my long-term impact on student engagement and motivation. While real-time feedback may help students improve, AI-driven assessment may reduce intrinsic motivation. Impersonal or mechanistic AI comments may deter students. AI-driven formative assessment systems may favor digitally savvy youngsters, creating a digital divide between students with and without home devices. Research suggests equitable access and teacher support enhance digital formative assessment (Borte et al., 2023). These worries suggest further research into how AI might boost student engagement and digital equity.

    My academic interests include education, technology, and assessment techniques. So, I am inspired by AI in assessment, and as someone interested in new teaching and learning approaches, personalized training and assessment using AI-driven technologies intrigues me. Teachers and students need to know how AI can improve formative assessment, which impacts student learning. I would like to understand how AI can help teachers with their decision-making while using technologies for education. When AI is integrated into education, ethics, and practical challenges arise: data privacy, risk of algorithmic bias, human assessment supervision, and others must be addressed. The research question I stated previously is “How could AI-embedded formative assessment improve personal feedback and decision-making in K-12 education, and what does that indicate for the workload and burden of teachers?” The research question has a transparent meaning for K-12 education and policy. Formative assessment with AI might revolutionize schools with scalable, tailored learning. However, educators and technology developers should collaborate to solve AI implementation challenges and make these tools effective and equitable. Also, this research may contribute to education technology discussions by examining how AI-driven formative assessment influences teacher and student learning. This work may inspire professional development programs to help educators employ AI-based assessment systems. As teachers' training delays technology uptake in education (Borte et al., 2023), practical professional development approaches are essential for this research.

    I aim to raise awareness of how AI may enhance formative assessment for equity, teacher burden, and student engagement. I want to answer my research question to produce ethical and practical AI-driven formative assessments. However, this work may shape future schooling to ensure AI supports teachers. Education must critically assess its effects to guarantee that AI breakthroughs match educational best practices and student learning objectives.

    **References**

    Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.
    _Sustainability_,
    _16_(17), 7826–7826. https://doi.org/10.3390/su16177826

    Weigand, H.-G., Trgalova, J., & Tabach, M. (2024). Mathematics teaching, learning, and assessment in the digital age.
    _ZDM_. https://doi.org/10.1007/s11858-024-01612-9

    **## Week4Assignment-v1.docx**

    Running head: THE SEARCH & ANNOTATED BIBLIOGRAPHY 2

    THE SEARCH & ANNOTATED BIBLIOGRAPHY 2

    **The Search & Annotated Bibliography**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    February 9, 2025

    **The Search & Annotated Bibliography**

    K-12 AI-embedded formative assessment may alter tailored learning and teaching. AI in formative examinations helps teachers provide more personalized feedback, saving time on grading. AI can identify knowledge gaps, track student progress, and personalize learning. However, its execution causes teacher load, student engagement, and equity issues. AI can automate and scale feedback, but it may depersonalize education and reduce instructors' formative assessment duties and feedback quality. Due to biases, AI systems may judge various student groups differently. This study critically analyses academic perspectives to examine the merits and downsides of AI-embedded formative assessment in the classroom. Fairness, teacher support and training, and AI technologies that enhance human participation in education will be prioritized. Understanding these interactions is essential for ethical K-12 formative assessment using AI.

    **Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.**
    **_Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568**

    Borte et al. (2023) provide a systematic review of formative assessment technology needs for teachers. The report uses 22 studies to examine teachers' adoption of digital tools. Evaluation topics include clear definitions of formative assessment and congruence with the instructional approach. This foundation helps teachers use technology without losing focus on educational goals. According to the review, instructors require data literacy to analyze and apply digital tool results to enhance student learning. The authors recommend teacher training, help, and stronger conceptual frameworks for formative assessment technology.

    Methodological rigor and peer-reviewed journal credibility improve systematic review findings. The authors' educational research, technology integration, and assessment competence validate their conclusions. Twenty-two studies fully cover instructor issues. Teaching training, more explicit frameworks, and more significant support systems are research contributions. The assessment may not provide educators with actionable recommendations. The study highlights crucial issues but does not provide an easy answer for teachers.

    Since it emphasizes the need to employ technology in assessment procedures, the relevance of this study to AI-embedded formative assessment is notable. Digital technology integration and data literacy training for teachers influence AI systems in formative assessment. This article emphasizes teacher readiness and strong conceptual frameworks to help K-12 education adopt AI technology. Unlike previous articles, the study focuses on AI applications rather than theory or technology. This tendency toward practical insights makes it a valuable resource for educators negotiating the challenges of introducing AI into assessment systems, especially as AI becomes more advanced and needs careful preparation.

    **Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.**
    **_Journal of Management Information Systems_,**
    **_40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775**

    Dolata et al. (2023) examine educational digital agents that might speak natural language to students. Digital agents' effects on learning outcomes and student-tool interactions are investigated using activity theory. Technology in the classroom affects students' behavior, according to activity theory. The study emphasizes digital agents' potential to provide customized, interactive learning experiences and proposes a paradigm for their use in education. The study illuminates how digital agents affect learning and how AI may enhance formative assessment.

    The authors, specialists in digital learning technologies and educational institutions, employ activity theory to support their conclusions. The study's methodologies and theoretical framework explain digital agents' involvement in education, establishing the platform for future research. Research on digital agents' influence on K-12 education is lacking. The theoretical investigation is intense, but real-world evidence on how these tools improve student results or teaching practices would deepen the case and illuminate the 12 formative assessments' practical consequences.
    The relevance of this study to AI-driven formative assessment is crucial because it explains how AI-powered digital agents might engage with students to deliver tailored learning and feedback. AI tool exploration overlaps with increased interest in how technology may improve formative assessment by personalizing feedback to specific students. Formative assessment aims to promote continuous, tailored learning, and the research provides a theoretical framework for AI's potential in personalized learning. Dolata et al. (2023) emphasize AI tool-learner interaction, unlike other sources that focus on practical issues and instructor preparation for AI integration. This new perspective on AI's educational function sheds light on how digital agents may change formative assessment and feedback.

    **Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.**
    **_Sustainability_,**
    **_16_(17), 7826–7826. https://doi.org/10.3390/su16177826**

    Sortwell et al. (2024) study meta-analyses to determine how formative assessment affects K-12 learning. According to the research, formative assessment improves student learning, although its impact varies by the type of assessment used. Feedback-based assessments perform better than formative tests, which may have variable outcomes. The analysis also shows that previous studies lack methodological rigor, highlighting the need for more substantial, long-term research on formative assessment, particularly when technology is included. The review contributes to understanding how formative assessment approaches might enhance educational results in K -12 settings by combining information from several meta-analyses.
    The authors assess many papers to ensure high-quality evidence, yet several meta-analyses in the study have low confidence. This suggests that the evaluation is based on a large body of research, but the evidence is inconsistent, and some findings may be unreliable. The work is published in Sustainability, a peer-reviewed education sustainability publication, ensuring academic credibility. However, AI-enhanced formative assessment techniques are underexplored. The evaluation focuses on conventional formative assessment approaches and their potential to improve learning outcomes, not AI systems.
    While Sortwell et al. (2024) do not concentrate on AI in formative assessment, their results provide a vital foundation for K-12 education. The review finding that formative assessment improves learning opens the door to potential advantages of AI-driven formative assessments. The research also contributes by examining formative assessment's efficiency, which is vital for assessing how AI technologies may be incorporated into such processes. This source emphasizes formative assessment's relevance in enhancing learning outcomes and highlights research gaps that might guide AI's application in formative assessment systems.

    **References**

    Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.
    _Sustainability_,
    _16_(17), 7826–7826. https://doi.org/10.3390/su16177826

    **Chptr1.pdf**

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    **Chptr2.pdf**

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    **Chptr2.pdf**

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    **## week5assignment.docx**

    ![null](https://www.sweetstudy.com/questions/education-edu530-week-5-assignment)

    ![icon](https://www.sweetstudy.com/questions/education-edu530-week-5-assignment)**_Findings and Implications of Your Discovery_**

    **Directions:**

    In this assignment, you will summarize the key findings from your research and discuss the implications of these findings. This part is crucial for highlighting what you have learned through your investigation and how these insights can be applied in a broader context.

    Follow the steps below to effectively present your findings and their implications.

    **Summarize Key Findings:**

    · Begin by clearly outlining the main discoveries or results of your research.

    · Present your findings in a logical order, using bullet points or subheadings if necessary to enhance clarity.

    · Ensure that you include quantitative data (if applicable), qualitative insights, and key themes that emerged from your analysis.

    **Interpret Your Findings:**

    · Provide your interpretation of what these findings mean in relation to your research question or topic.

    · Discuss any surprising results or trends that you observed and why they are significant.

    · Reference any relevant theories, concepts, or frameworks that can help contextualize your findings.

    **Discuss Implications:**

    · Explore the broader implications of your findings for your field of study, industry, or society as a whole.

    · Consider the practical applications of your discoveries. How might they inform policy, practice, or further research?

    · Address any potential limitations or challenges in applying your findings, as well as suggestions for overcoming them.

    **Suggest Future Research Directions:**

    · Based on your findings, propose areas for future research or questions that remain unanswered.

    · Highlight how further investigation could build on your work or contribute to a deeper understanding of the topic.

    **Organize Your Section:**

    · Use clear headings and subheadings to differentiate between findings and implications.

    · Ensure that your writing is concise and focused, providing enough detail to convey your points effectively.

    Combine all the components into a whole and submit your completed research paper.

    **Submission Instructions:**

    · The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.

    · The paper should be formatted per current APA and 10-15 pages in length, excluding the title, abstract and references page. Incorporate a minimum of 6-8 current (published within the last five years) scholarly journal articles within your work.

    · This assignment will be assessed through Turnitin.

    ## image1.png

    ## image2.png

    **## Week2Assignment-v1.docx**

    Running head: DIGITAL TOOL IN EDUCATION AND FORMATIVE ASSESSMENT 2

    DIGITAL TOOLS IN EDUCATION AND FORMATIVE ASSESSMENT 2

    **Digital Tools in Education and Formative Assessment**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    January 26, 2025

    Digital Tools in Education and Formative Assessment

    **Step 1: Topic Exploration**

    Chosen Topic: Digital Tools in Education and Formative Assessment

    **Research Summary:**
    Digital tools included in education and formative assessment are the go-to in education. The three findings from the peer-reviewed research disclose the following:

    1.
    **Challenges in Teachers' Adoption:** Borte et al. (2023) highlight that incongruence in the realm of technology versus pedagogy prevents teachers from taking advantage of the full potential inherent in digital tools-stimulating student-centered learning or even formative assessment practices definition and more teacher training in data literacy.

    2.
    **Evidence of Effectiveness:** According to Sortwell et al. (2024), formative assessment practices positively influence the learning process for students in K-12 if done appropriately. However, more research is needed, given the low certainty of evidence concerning optimal strategies.

    3.
    **Personalized Learning:** Weigand, Trgalova, and Tabach (2024) have discussed how digital tools, especially adaptive systems, allow individualized learning experiences and formative assessments in mathematics education. These tools provide real-time feedback that helps students and teachers address specific learning needs.

    4.
    **Gaps in Current Research**
    **_:_** All three note that digital formative assessment strategies' effectiveness and long-term impact on students' engagement and outcomes remain under-researched.

    5.
    **Challenges for Teachers:** Some challenges that hold back teachers are the limitations of the technology itself, the lack of training to use these technologies, and the lack of research on best practices for using these technologies within formative assessment.

    **Step 2: Narrow Focus**

    **Narrowed Topic:**

    The potential of Artificial Intelligence (AI) ventures to realize an impact on enhancing formative assessment through personalized feedback and specific challenges in teachers' implementation of ventures.

    **Relevance to Assessment and Measurement:**

    This topic is relevant because formative assessment is a cornerstone of effective teaching and learning. Other challenges include equity, teacher autonomy, and professional development when integrating AI. It can lead to insightful ways to design practical AI-driven formative assessment tools and further knowledge of the broader implications for K-12 education.

    **Step 3: Crafting the Guiding Question**

    **Guiding Research Question:**

    How could AI-embedded formative assessment improve personal feedback and decision-making in K-12 education, and what does that indicate for the workload and burden of teachers?

    **Rationale:**

    The guiding question cuts into what is critical and timely: technology and education must work at a crossroads that transform AI possibilities within formative assessment. Therefore, it is because AI provides unlimited ways of constructing productive personalized feedback that can eventually be useful to teachers and educators in providing teaching strategies that can accommodate needs that will be different for different learners; it promises improved results in better learning. For example, it would not be easy to get data education for those teachers by using new technologies and weighing those tools with professional judgment. However, there is an entire issue of equity, access, and ethical issues regarding the use of AI in many K-12 settings. In keeping with the ongoing debate about new inventions in measurement and assessment, there seems to be some search for possibilities in harmony with restrictions about the prospect and usage of formative assessments via AI. For these reasons, such research allows for actual development in ways that will help make any final equitable, vigorous AI-supported assessments feed into teachers and eventually improve the quality of teaching and learning for a regiment of students across all contexts. Additionally, frameworks like the Learning-with-PA Model highlight the importance of contextual factors and digital agents in mediating learning outcomes (Dolata et al., 2023).

    **References**

    Børte, K., Lillejord, S., Chan, J., Lillehaug, B. W., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _100568 ; Educational Research Review ; 41_.
    [https://doi.org/10.1016/j.edurev.2023.100568](https://doi.org/10.1016/j.edurev.2023.100568)

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Carter-Thuiller, B., Gkintoni, E., & Xuan, Q. (2024). A Systematic Review of Meta-Analyses on the Impact of Formative Assessment on K-12 Students’ Learning: Toward Sustainable Quality Education.
    _Sustainability_,
    _16_(17), NA. https://doi.org/10.3390/su16177826

    Weigand, H.-G., Trgalova, J., & Tabach, M. (2024). Mathematics teaching, learning, and assessment in the digital age.
    _ZDM_,
    _56_. https://doi.org/10.1007/s11858-024-01612-9

    **## Week3Assignment-v1.docx**

    Running head: THE BASED OF PREDICTIONS & RATIONALE 2

    THE BASE OF PREDICTIONS & RATIONAL 2

    **The Base of Predictions & Rationale**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    February 2, 2025

    **The Base of Predictions & Rational**

    The growing use of digital technologies in education informs my understanding of AI's potential in formative assessment. AI is used in educational technology to deliver real-time feedback, tailor learning, and help instructors. According to my coursework and readings, formative evaluation allows instructors to detect knowledge gaps, measure progress, and alter teaching (Sortwell et al., 2024). However, AI's ability to improve formative assessment faces severe practical difficulties. Many instructors have challenges using AI-driven formative assessment systems because of insufficient training, equity issues, and technical limits (Børte et al., 2023). AI can create individualized feedback on a scale, but its quality and trustworthiness compared to human review are disputed.

    One of my primary assumptions is that AI-embedded formative assessment will enhance K-12 individualized feedback and decision-making. Previous research has shown that AI can assess student replies, discover trends, and customize feedback to specific learning requirements (Weigand et al., 2024). AI-driven assessment systems might save instructors from grading and assessing student work, letting them concentrate on teaching and student engagement. However, AI may depersonalize education and reduce instructors' participation in formative evaluation. I assume that AI models are bias-free, yet research reveals that many AI systems inherit biases from their training data, which might lead to inequitable evaluation results (Dolata et al., 2023). Identifying bias in AI models raises questions about how AI-generated feedback can affect diverse student groups, especially underprivileged ones.

    The prediction is that AI-embedded formative assessment systems will reduce teacher effort as they improve. Formative assessment is time-consuming. Therefore, AI's capacity to automate processes like grading multiple-choice questions, delivering quick feedback, and creating progress reports should help instructors save time. However, instructors must still analyze AI-generated insights and ensure that feedback meets students' requirements. Higher-order thinking abilities like critical analysis and creativity are frequently best assessed via open-ended replies and classroom discussions. AI may not be able to do so. While AI has shown potential in essay scoring and natural language processing, its capacity to deliver nuanced feedback on complicated student work needs additional study (Sortwell et al., 2024). AI will complement teacher-driven formative evaluation, not replace it.

    One of my uncertainties regarding AI-embedded formative evaluation is my long-term impact on student engagement and motivation. While real-time feedback may help students improve, AI-driven assessment may reduce intrinsic motivation. Impersonal or mechanistic AI comments may deter students. AI-driven formative assessment systems may favor digitally savvy youngsters, creating a digital divide between students with and without home devices. Research suggests equitable access and teacher support enhance digital formative assessment (Borte et al., 2023). These worries suggest further research into how AI might boost student engagement and digital equity.

    My academic interests include education, technology, and assessment techniques. So, I am inspired by AI in assessment, and as someone interested in new teaching and learning approaches, personalized training and assessment using AI-driven technologies intrigues me. Teachers and students need to know how AI can improve formative assessment, which impacts student learning. I would like to understand how AI can help teachers with their decision-making while using technologies for education. When AI is integrated into education, ethics, and practical challenges arise: data privacy, risk of algorithmic bias, human assessment supervision, and others must be addressed. The research question I stated previously is “How could AI-embedded formative assessment improve personal feedback and decision-making in K-12 education, and what does that indicate for the workload and burden of teachers?” The research question has a transparent meaning for K-12 education and policy. Formative assessment with AI might revolutionize schools with scalable, tailored learning. However, educators and technology developers should collaborate to solve AI implementation challenges and make these tools effective and equitable. Also, this research may contribute to education technology discussions by examining how AI-driven formative assessment influences teacher and student learning. This work may inspire professional development programs to help educators employ AI-based assessment systems. As teachers' training delays technology uptake in education (Borte et al., 2023), practical professional development approaches are essential for this research.

    I aim to raise awareness of how AI may enhance formative assessment for equity, teacher burden, and student engagement. I want to answer my research question to produce ethical and practical AI-driven formative assessments. However, this work may shape future schooling to ensure AI supports teachers. Education must critically assess its effects to guarantee that AI breakthroughs match educational best practices and student learning objectives.

    **References**

    Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.
    _Sustainability_,
    _16_(17), 7826–7826. https://doi.org/10.3390/su16177826

    Weigand, H.-G., Trgalova, J., & Tabach, M. (2024). Mathematics teaching, learning, and assessment in the digital age.
    _ZDM_. https://doi.org/10.1007/s11858-024-01612-9

    **## Week4Assignment-v1.docx**

    Running head: THE SEARCH & ANNOTATED BIBLIOGRAPHY 2

    THE SEARCH & ANNOTATED BIBLIOGRAPHY 2

    **The Search & Annotated Bibliography**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    February 9, 2025

    **The Search & Annotated Bibliography**

    K-12 AI-embedded formative assessment may alter tailored learning and teaching. AI in formative examinations helps teachers provide more personalized feedback, saving time on grading. AI can identify knowledge gaps, track student progress, and personalize learning. However, its execution causes teacher load, student engagement, and equity issues. AI can automate and scale feedback, but it may depersonalize education and reduce instructors' formative assessment duties and feedback quality. Due to biases, AI systems may judge various student groups differently. This study critically analyses academic perspectives to examine the merits and downsides of AI-embedded formative assessment in the classroom. Fairness, teacher support and training, and AI technologies that enhance human participation in education will be prioritized. Understanding these interactions is essential for ethical K-12 formative assessment using AI.

    **Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.**
    **_Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568**

    Borte et al. (2023) provide a systematic review of formative assessment technology needs for teachers. The report uses 22 studies to examine teachers' adoption of digital tools. Evaluation topics include clear definitions of formative assessment and congruence with the instructional approach. This foundation helps teachers use technology without losing focus on educational goals. According to the review, instructors require data literacy to analyze and apply digital tool results to enhance student learning. The authors recommend teacher training, help, and stronger conceptual frameworks for formative assessment technology.

    Methodological rigor and peer-reviewed journal credibility improve systematic review findings. The authors' educational research, technology integration, and assessment competence validate their conclusions. Twenty-two studies fully cover instructor issues. Teaching training, more explicit frameworks, and more significant support systems are research contributions. The assessment may not provide educators with actionable recommendations. The study highlights crucial issues but does not provide an easy answer for teachers.

    Since it emphasizes the need to employ technology in assessment procedures, the relevance of this study to AI-embedded formative assessment is notable. Digital technology integration and data literacy training for teachers influence AI systems in formative assessment. This article emphasizes teacher readiness and strong conceptual frameworks to help K-12 education adopt AI technology. Unlike previous articles, the study focuses on AI applications rather than theory or technology. This tendency toward practical insights makes it a valuable resource for educators negotiating the challenges of introducing AI into assessment systems, especially as AI becomes more advanced and needs careful preparation.

    **Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.**
    **_Journal of Management Information Systems_,**
    **_40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775**

    Dolata et al. (2023) examine educational digital agents that might speak natural language to students. Digital agents' effects on learning outcomes and student-tool interactions are investigated using activity theory. Technology in the classroom affects students' behavior, according to activity theory. The study emphasizes digital agents' potential to provide customized, interactive learning experiences and proposes a paradigm for their use in education. The study illuminates how digital agents affect learning and how AI may enhance formative assessment.

    The authors, specialists in digital learning technologies and educational institutions, employ activity theory to support their conclusions. The study's methodologies and theoretical framework explain digital agents' involvement in education, establishing the platform for future research. Research on digital agents' influence on K-12 education is lacking. The theoretical investigation is intense, but real-world evidence on how these tools improve student results or teaching practices would deepen the case and illuminate the 12 formative assessments' practical consequences.
    The relevance of this study to AI-driven formative assessment is crucial because it explains how AI-powered digital agents might engage with students to deliver tailored learning and feedback. AI tool exploration overlaps with increased interest in how technology may improve formative assessment by personalizing feedback to specific students. Formative assessment aims to promote continuous, tailored learning, and the research provides a theoretical framework for AI's potential in personalized learning. Dolata et al. (2023) emphasize AI tool-learner interaction, unlike other sources that focus on practical issues and instructor preparation for AI integration. This new perspective on AI's educational function sheds light on how digital agents may change formative assessment and feedback.

    **Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.**
    **_Sustainability_,**
    **_16_(17), 7826–7826. https://doi.org/10.3390/su16177826**

    Sortwell et al. (2024) study meta-analyses to determine how formative assessment affects K-12 learning. According to the research, formative assessment improves student learning, although its impact varies by the type of assessment used. Feedback-based assessments perform better than formative tests, which may have variable outcomes. The analysis also shows that previous studies lack methodological rigor, highlighting the need for more substantial, long-term research on formative assessment, particularly when technology is included. The review contributes to understanding how formative assessment approaches might enhance educational results in K -12 settings by combining information from several meta-analyses.
    The authors assess many papers to ensure high-quality evidence, yet several meta-analyses in the study have low confidence. This suggests that the evaluation is based on a large body of research, but the evidence is inconsistent, and some findings may be unreliable. The work is published in Sustainability, a peer-reviewed education sustainability publication, ensuring academic credibility. However, AI-enhanced formative assessment techniques are underexplored. The evaluation focuses on conventional formative assessment approaches and their potential to improve learning outcomes, not AI systems.
    While Sortwell et al. (2024) do not concentrate on AI in formative assessment, their results provide a vital foundation for K-12 education. The review finding that formative assessment improves learning opens the door to potential advantages of AI-driven formative assessments. The research also contributes by examining formative assessment's efficiency, which is vital for assessing how AI technologies may be incorporated into such processes. This source emphasizes formative assessment's relevance in enhancing learning outcomes and highlights research gaps that might guide AI's application in formative assessment systems.

    **References**

    Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.
    _Sustainability_,
    _16_(17), 7826–7826. https://doi.org/10.3390/su16177826

    **Chptr1.pdf**

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    **Chptr2.pdf**

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    **## week5assignment.docx**

    ![null](https://www.sweetstudy.com/questions/education-edu530-week-5-assignment)

    ![icon](https://www.sweetstudy.com/questions/education-edu530-week-5-assignment)**_Findings and Implications of Your Discovery_**

    **Directions:**

    In this assignment, you will summarize the key findings from your research and discuss the implications of these findings. This part is crucial for highlighting what you have learned through your investigation and how these insights can be applied in a broader context.

    Follow the steps below to effectively present your findings and their implications.

    **Summarize Key Findings:**

    · Begin by clearly outlining the main discoveries or results of your research.

    · Present your findings in a logical order, using bullet points or subheadings if necessary to enhance clarity.

    · Ensure that you include quantitative data (if applicable), qualitative insights, and key themes that emerged from your analysis.

    **Interpret Your Findings:**

    · Provide your interpretation of what these findings mean in relation to your research question or topic.

    · Discuss any surprising results or trends that you observed and why they are significant.

    · Reference any relevant theories, concepts, or frameworks that can help contextualize your findings.

    **Discuss Implications:**

    · Explore the broader implications of your findings for your field of study, industry, or society as a whole.

    · Consider the practical applications of your discoveries. How might they inform policy, practice, or further research?

    · Address any potential limitations or challenges in applying your findings, as well as suggestions for overcoming them.

    **Suggest Future Research Directions:**

    · Based on your findings, propose areas for future research or questions that remain unanswered.

    · Highlight how further investigation could build on your work or contribute to a deeper understanding of the topic.

    **Organize Your Section:**

    · Use clear headings and subheadings to differentiate between findings and implications.

    · Ensure that your writing is concise and focused, providing enough detail to convey your points effectively.

    Combine all the components into a whole and submit your completed research paper.

    **Submission Instructions:**

    · The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.

    · The paper should be formatted per current APA and 10-15 pages in length, excluding the title, abstract and references page. Incorporate a minimum of 6-8 current (published within the last five years) scholarly journal articles within your work.

    · This assignment will be assessed through Turnitin.

    ## image1.png

    ## image2.png

    **## Week2Assignment-v1.docx**

    Running head: DIGITAL TOOL IN EDUCATION AND FORMATIVE ASSESSMENT 2

    DIGITAL TOOLS IN EDUCATION AND FORMATIVE ASSESSMENT 2

    **Digital Tools in Education and Formative Assessment**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    January 26, 2025

    Digital Tools in Education and Formative Assessment

    **Step 1: Topic Exploration**

    Chosen Topic: Digital Tools in Education and Formative Assessment

    **Research Summary:**
    Digital tools included in education and formative assessment are the go-to in education. The three findings from the peer-reviewed research disclose the following:

    1.
    **Challenges in Teachers' Adoption:** Borte et al. (2023) highlight that incongruence in the realm of technology versus pedagogy prevents teachers from taking advantage of the full potential inherent in digital tools-stimulating student-centered learning or even formative assessment practices definition and more teacher training in data literacy.

    2.
    **Evidence of Effectiveness:** According to Sortwell et al. (2024), formative assessment practices positively influence the learning process for students in K-12 if done appropriately. However, more research is needed, given the low certainty of evidence concerning optimal strategies.

    3.
    **Personalized Learning:** Weigand, Trgalova, and Tabach (2024) have discussed how digital tools, especially adaptive systems, allow individualized learning experiences and formative assessments in mathematics education. These tools provide real-time feedback that helps students and teachers address specific learning needs.

    4.
    **Gaps in Current Research**
    **_:_** All three note that digital formative assessment strategies' effectiveness and long-term impact on students' engagement and outcomes remain under-researched.

    5.
    **Challenges for Teachers:** Some challenges that hold back teachers are the limitations of the technology itself, the lack of training to use these technologies, and the lack of research on best practices for using these technologies within formative assessment.

    **Step 2: Narrow Focus**

    **Narrowed Topic:**

    The potential of Artificial Intelligence (AI) ventures to realize an impact on enhancing formative assessment through personalized feedback and specific challenges in teachers' implementation of ventures.

    **Relevance to Assessment and Measurement:**

    This topic is relevant because formative assessment is a cornerstone of effective teaching and learning. Other challenges include equity, teacher autonomy, and professional development when integrating AI. It can lead to insightful ways to design practical AI-driven formative assessment tools and further knowledge of the broader implications for K-12 education.

    **Step 3: Crafting the Guiding Question**

    **Guiding Research Question:**

    How could AI-embedded formative assessment improve personal feedback and decision-making in K-12 education, and what does that indicate for the workload and burden of teachers?

    **Rationale:**

    The guiding question cuts into what is critical and timely: technology and education must work at a crossroads that transform AI possibilities within formative assessment. Therefore, it is because AI provides unlimited ways of constructing productive personalized feedback that can eventually be useful to teachers and educators in providing teaching strategies that can accommodate needs that will be different for different learners; it promises improved results in better learning. For example, it would not be easy to get data education for those teachers by using new technologies and weighing those tools with professional judgment. However, there is an entire issue of equity, access, and ethical issues regarding the use of AI in many K-12 settings. In keeping with the ongoing debate about new inventions in measurement and assessment, there seems to be some search for possibilities in harmony with restrictions about the prospect and usage of formative assessments via AI. For these reasons, such research allows for actual development in ways that will help make any final equitable, vigorous AI-supported assessments feed into teachers and eventually improve the quality of teaching and learning for a regiment of students across all contexts. Additionally, frameworks like the Learning-with-PA Model highlight the importance of contextual factors and digital agents in mediating learning outcomes (Dolata et al., 2023).

    **References**

    Børte, K., Lillejord, S., Chan, J., Lillehaug, B. W., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _100568 ; Educational Research Review ; 41_.
    [https://doi.org/10.1016/j.edurev.2023.100568](https://doi.org/10.1016/j.edurev.2023.100568)

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Carter-Thuiller, B., Gkintoni, E., & Xuan, Q. (2024). A Systematic Review of Meta-Analyses on the Impact of Formative Assessment on K-12 Students’ Learning: Toward Sustainable Quality Education.
    _Sustainability_,
    _16_(17), NA. https://doi.org/10.3390/su16177826

    Weigand, H.-G., Trgalova, J., & Tabach, M. (2024). Mathematics teaching, learning, and assessment in the digital age.
    _ZDM_,
    _56_. https://doi.org/10.1007/s11858-024-01612-9

    **## Week3Assignment-v1.docx**

    Running head: THE BASED OF PREDICTIONS & RATIONALE 2

    THE BASE OF PREDICTIONS & RATIONAL 2

    **The Base of Predictions & Rationale**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    February 2, 2025

    **The Base of Predictions & Rational**

    The growing use of digital technologies in education informs my understanding of AI's potential in formative assessment. AI is used in educational technology to deliver real-time feedback, tailor learning, and help instructors. According to my coursework and readings, formative evaluation allows instructors to detect knowledge gaps, measure progress, and alter teaching (Sortwell et al., 2024). However, AI's ability to improve formative assessment faces severe practical difficulties. Many instructors have challenges using AI-driven formative assessment systems because of insufficient training, equity issues, and technical limits (Børte et al., 2023). AI can create individualized feedback on a scale, but its quality and trustworthiness compared to human review are disputed.

    One of my primary assumptions is that AI-embedded formative assessment will enhance K-12 individualized feedback and decision-making. Previous research has shown that AI can assess student replies, discover trends, and customize feedback to specific learning requirements (Weigand et al., 2024). AI-driven assessment systems might save instructors from grading and assessing student work, letting them concentrate on teaching and student engagement. However, AI may depersonalize education and reduce instructors' participation in formative evaluation. I assume that AI models are bias-free, yet research reveals that many AI systems inherit biases from their training data, which might lead to inequitable evaluation results (Dolata et al., 2023). Identifying bias in AI models raises questions about how AI-generated feedback can affect diverse student groups, especially underprivileged ones.

    The prediction is that AI-embedded formative assessment systems will reduce teacher effort as they improve. Formative assessment is time-consuming. Therefore, AI's capacity to automate processes like grading multiple-choice questions, delivering quick feedback, and creating progress reports should help instructors save time. However, instructors must still analyze AI-generated insights and ensure that feedback meets students' requirements. Higher-order thinking abilities like critical analysis and creativity are frequently best assessed via open-ended replies and classroom discussions. AI may not be able to do so. While AI has shown potential in essay scoring and natural language processing, its capacity to deliver nuanced feedback on complicated student work needs additional study (Sortwell et al., 2024). AI will complement teacher-driven formative evaluation, not replace it.

    One of my uncertainties regarding AI-embedded formative evaluation is my long-term impact on student engagement and motivation. While real-time feedback may help students improve, AI-driven assessment may reduce intrinsic motivation. Impersonal or mechanistic AI comments may deter students. AI-driven formative assessment systems may favor digitally savvy youngsters, creating a digital divide between students with and without home devices. Research suggests equitable access and teacher support enhance digital formative assessment (Borte et al., 2023). These worries suggest further research into how AI might boost student engagement and digital equity.

    My academic interests include education, technology, and assessment techniques. So, I am inspired by AI in assessment, and as someone interested in new teaching and learning approaches, personalized training and assessment using AI-driven technologies intrigues me. Teachers and students need to know how AI can improve formative assessment, which impacts student learning. I would like to understand how AI can help teachers with their decision-making while using technologies for education. When AI is integrated into education, ethics, and practical challenges arise: data privacy, risk of algorithmic bias, human assessment supervision, and others must be addressed. The research question I stated previously is “How could AI-embedded formative assessment improve personal feedback and decision-making in K-12 education, and what does that indicate for the workload and burden of teachers?” The research question has a transparent meaning for K-12 education and policy. Formative assessment with AI might revolutionize schools with scalable, tailored learning. However, educators and technology developers should collaborate to solve AI implementation challenges and make these tools effective and equitable. Also, this research may contribute to education technology discussions by examining how AI-driven formative assessment influences teacher and student learning. This work may inspire professional development programs to help educators employ AI-based assessment systems. As teachers' training delays technology uptake in education (Borte et al., 2023), practical professional development approaches are essential for this research.

    I aim to raise awareness of how AI may enhance formative assessment for equity, teacher burden, and student engagement. I want to answer my research question to produce ethical and practical AI-driven formative assessments. However, this work may shape future schooling to ensure AI supports teachers. Education must critically assess its effects to guarantee that AI breakthroughs match educational best practices and student learning objectives.

    **References**

    Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.
    _Sustainability_,
    _16_(17), 7826–7826. https://doi.org/10.3390/su16177826

    Weigand, H.-G., Trgalova, J., & Tabach, M. (2024). Mathematics teaching, learning, and assessment in the digital age.
    _ZDM_. https://doi.org/10.1007/s11858-024-01612-9

    **## Week4Assignment-v1.docx**

    Running head: THE SEARCH & ANNOTATED BIBLIOGRAPHY 2

    THE SEARCH & ANNOTATED BIBLIOGRAPHY 2

    **The Search & Annotated Bibliography**

    St Thomas University

    EDU 530 Educational Measurement

    Dr. Pamela Dahlin

    February 9, 2025

    **The Search & Annotated Bibliography**

    K-12 AI-embedded formative assessment may alter tailored learning and teaching. AI in formative examinations helps teachers provide more personalized feedback, saving time on grading. AI can identify knowledge gaps, track student progress, and personalize learning. However, its execution causes teacher load, student engagement, and equity issues. AI can automate and scale feedback, but it may depersonalize education and reduce instructors' formative assessment duties and feedback quality. Due to biases, AI systems may judge various student groups differently. This study critically analyses academic perspectives to examine the merits and downsides of AI-embedded formative assessment in the classroom. Fairness, teacher support and training, and AI technologies that enhance human participation in education will be prioritized. Understanding these interactions is essential for ethical K-12 formative assessment using AI.

    **Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.**
    **_Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568**

    Borte et al. (2023) provide a systematic review of formative assessment technology needs for teachers. The report uses 22 studies to examine teachers' adoption of digital tools. Evaluation topics include clear definitions of formative assessment and congruence with the instructional approach. This foundation helps teachers use technology without losing focus on educational goals. According to the review, instructors require data literacy to analyze and apply digital tool results to enhance student learning. The authors recommend teacher training, help, and stronger conceptual frameworks for formative assessment technology.

    Methodological rigor and peer-reviewed journal credibility improve systematic review findings. The authors' educational research, technology integration, and assessment competence validate their conclusions. Twenty-two studies fully cover instructor issues. Teaching training, more explicit frameworks, and more significant support systems are research contributions. The assessment may not provide educators with actionable recommendations. The study highlights crucial issues but does not provide an easy answer for teachers.

    Since it emphasizes the need to employ technology in assessment procedures, the relevance of this study to AI-embedded formative assessment is notable. Digital technology integration and data literacy training for teachers influence AI systems in formative assessment. This article emphasizes teacher readiness and strong conceptual frameworks to help K-12 education adopt AI technology. Unlike previous articles, the study focuses on AI applications rather than theory or technology. This tendency toward practical insights makes it a valuable resource for educators negotiating the challenges of introducing AI into assessment systems, especially as AI becomes more advanced and needs careful preparation.

    **Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.**
    **_Journal of Management Information Systems_,**
    **_40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775**

    Dolata et al. (2023) examine educational digital agents that might speak natural language to students. Digital agents' effects on learning outcomes and student-tool interactions are investigated using activity theory. Technology in the classroom affects students' behavior, according to activity theory. The study emphasizes digital agents' potential to provide customized, interactive learning experiences and proposes a paradigm for their use in education. The study illuminates how digital agents affect learning and how AI may enhance formative assessment.

    The authors, specialists in digital learning technologies and educational institutions, employ activity theory to support their conclusions. The study's methodologies and theoretical framework explain digital agents' involvement in education, establishing the platform for future research. Research on digital agents' influence on K-12 education is lacking. The theoretical investigation is intense, but real-world evidence on how these tools improve student results or teaching practices would deepen the case and illuminate the 12 formative assessments' practical consequences.
    The relevance of this study to AI-driven formative assessment is crucial because it explains how AI-powered digital agents might engage with students to deliver tailored learning and feedback. AI tool exploration overlaps with increased interest in how technology may improve formative assessment by personalizing feedback to specific students. Formative assessment aims to promote continuous, tailored learning, and the research provides a theoretical framework for AI's potential in personalized learning. Dolata et al. (2023) emphasize AI tool-learner interaction, unlike other sources that focus on practical issues and instructor preparation for AI integration. This new perspective on AI's educational function sheds light on how digital agents may change formative assessment and feedback.

    **Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.**
    **_Sustainability_,**
    **_16_(17), 7826–7826. https://doi.org/10.3390/su16177826**

    Sortwell et al. (2024) study meta-analyses to determine how formative assessment affects K-12 learning. According to the research, formative assessment improves student learning, although its impact varies by the type of assessment used. Feedback-based assessments perform better than formative tests, which may have variable outcomes. The analysis also shows that previous studies lack methodological rigor, highlighting the need for more substantial, long-term research on formative assessment, particularly when technology is included. The review contributes to understanding how formative assessment approaches might enhance educational results in K -12 settings by combining information from several meta-analyses.
    The authors assess many papers to ensure high-quality evidence, yet several meta-analyses in the study have low confidence. This suggests that the evaluation is based on a large body of research, but the evidence is inconsistent, and some findings may be unreliable. The work is published in Sustainability, a peer-reviewed education sustainability publication, ensuring academic credibility. However, AI-enhanced formative assessment techniques are underexplored. The evaluation focuses on conventional formative assessment approaches and their potential to improve learning outcomes, not AI systems.
    While Sortwell et al. (2024) do not concentrate on AI in formative assessment, their results provide a vital foundation for K-12 education. The review finding that formative assessment improves learning opens the door to potential advantages of AI-driven formative assessments. The research also contributes by examining formative assessment's efficiency, which is vital for assessing how AI technologies may be incorporated into such processes. This source emphasizes formative assessment's relevance in enhancing learning outcomes and highlights research gaps that might guide AI's application in formative assessment systems.

    **References**

    Borte, K., Lillejord, S., Erduran, S., Wasson, B., & Greiff, S. (2023). Prerequisites for teachers’ technology use in formative assessment practices: A systematic review.
    _Educational Research Review_, 100568–100568. https://doi.org/10.1016/j.edurev.2023.100568

    Dolata, M., Katsiuba, D., Wellnhammer, N., & Schwabe, G. (2023). Learning with Digital Agents: An Analysis based on the Activity Theory.
    _Journal of Management Information Systems_,
    _40_(1), 56–95. https://doi.org/10.1080/07421222.2023.2172775

    Sortwell, A., Trimble, K., Ferraz, R., Geelan, D. R., Hine, G., Ramirez-Campillo, R., Bastian Carter-Thuiller, E. Gkintoni, & Xuan, Q. (2024). A systematic review of meta-analyses on the impact of formative assessment on K-12 students’ learning: Toward sustainable quality education.
    _Sustainability_,
    _16_(17), 7826–7826. https://doi.org/10.3390/su16177826

    **Chptr1.pdf**

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  • [Solved] Education Death and Stages of Grief Assignment

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – 2 years ago **files (1)** – ## StagesofGriefAssignment.docx **## StagesofGriefAssignment.docx** PLEASE USE NO AI OR CHAT GPT Write a 750-1,000-word paper analyzing Wolterstorff's reflections in _Lament for a Son_. In addition, address Kubler-Ross's five stages of grief, as they are expressed throu…

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    – 2 years ago

    **files (1)**

    – ## StagesofGriefAssignment.docx

    **## StagesofGriefAssignment.docx**

    PLEASE USE NO AI OR CHAT GPT

    Write a 750-1,000-word paper analyzing Wolterstorff's reflections in
    _Lament for a Son_. In addition, address Kubler-Ross's five stages of grief, as they are expressed throughout
    _Lament for a Son_, and respond to the following questions:

    1. Explain the medical and philosophical meaning of death.

    2. Explain the five stages of grief and identify them in Wolterstorff's experiences.

    3. How does Wolterstorff find joy after his loss? How does the hope of the resurrection play a role in comforting Wolterstorff?

    4. What is the meaning and significance of death in light of the Christian narrative?

    5. What is the importance of understanding the grieving process, approaches, and practices in various faith traditions different than one's own?

    Remember to support your responses with the topic Resources.

    PLEASE USE REFERENCES

    **## StagesofGriefAssignment.docx**

    PLEASE USE NO AI OR CHAT GPT

    Write a 750-1,000-word paper analyzing Wolterstorff's reflections in
    _Lament for a Son_. In addition, address Kubler-Ross's five stages of grief, as they are expressed throughout
    _Lament for a Son_, and respond to the following questions:

    1. Explain the medical and philosophical meaning of death.

    2. Explain the five stages of grief and identify them in Wolterstorff's experiences.

    3. How does Wolterstorff find joy after his loss? How does the hope of the resurrection play a role in comforting Wolterstorff?

    4. What is the meaning and significance of death in light of the Christian narrative?

    5. What is the importance of understanding the grieving process, approaches, and practices in various faith traditions different than one's own?

    Remember to support your responses with the topic Resources.

    PLEASE USE REFERENCES