NRS 428 Case Study Evaluate the Health History and Medical Information for Mr. C

Sample Answer for NRS 428 Case Study Evaluate the Health History and Medical Information for Mr. C Included After Question

Assessment Description

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

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Objective Data:

Height: 68 inches; weight 134.5 kg
BP: 172/98, HR 88, RR 26
3+ pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
BUN 32 mg/dl

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

Describe the clinical manifestations present in Mr. C.
Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years

NRS 428 Case Study Evaluate the Health History and Medical Information for Mr. C

and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

A Sample Answer For the Assignment: NRS 428 Case Study Evaluate the Health History and Medical Information for Mr. C

Title: NRS 428 Case Study Evaluate the Health History and Medical Information for Mr. C

The case study concerns Mr. M 70-year-old male living at an assisted living facility. The patient’s health status has rapidly deteriorated in the past two months. He struggles to remember his family members’ names and room number and repeats things he has read. Mr. M quickly becomes agitated and aggressive. The purpose of this assignment is to analyze Mr. M’s health condition and interventions to support him and the family.

Clinical Manifestations of Mr. M.

Mr. M exhibits clinical manifestation of cognitive decline in memory as seen by forgetting family members’ names and room number and getting lost. He has mood symptoms, as evidenced by getting quickly agitated and aggressive. In addition, the patient has difficulties performing ADLs independently. The patient is overweight, with a BMI of 27.9. Diagnostic results show that the patient has leukocytosis and lymphocytosis. Urinalysis results reveal cloudy urine and leukocytes, indicating a possible urinary tract infection (UTI).

Diagnoses and Secondary Diagnoses

The primary diagnosis is Alzheimer’s dementia (AD). The patient demonstrates positive AD symptoms like a gradual decline in memory, difficulties remembering familiar names and places, confusion with wandering at night, aggression and agitation, reading difficulties, and inability to perform ADLs independently (Tahami Monfared et al., 2022).

The secondary diagnosis is Asymptomatic Bacteriuria (ABU). ABU is characterized by leukocytes on urinalysis but with no reported clinical symptoms of UTI. Persons living with dementia often have atypical clinical manifestations and high ABU rates (Yourman et al., 2020). The patient has not expressed any symptoms consistent with UTI, but urinalysis results of cloudy urine and leukocytes indicate UTI, making ABU the secondary diagnosis. The nursing diagnosis derived from AD is Impaired memory related to chemical imbalances in the brain as evidenced by memory loss. The nurse should consider this diagnosis by evaluating the patient’s cognitive function and memory.

Expected Abnormalities during Nursing Assessment

Abnormal findings are expected in nursing assessment in the general, neurological, and mental status assessment based on the AD medical diagnosis. On general assessment, the nurse can expect to find a nervous, restless, and disoriented patient with explosive behavior when asked about his cognitive decline symptoms (Tahami Monfared et al., 2022). The patient may also exhibit paranoia and inappropriate social behavior. The likely neurological exam findings include short-term memory loss, reduced attention span, dysarthria, and impaired executive functioning.

The expected abnormal mental status exam (MSE) findings include disorganization, disorientation to time, place, and person, impaired reasoning, abstract thought and judgment, problems with calculation, and decreased attention span. In addition, the patient may demonstrate deterioration in personal care and appearance and have poor cooperation (Tahami Monfared et al., 2022). The nurse may not identify any abnormal findings with ABU because it is asymptomatic. However, a thorough genitourinary exam is crucial to identify if the patient has costovertebral angle tenderness, penile ulcers or lesions, scrotal tenderness, meatal discharge, or prostatic tenderness.

Health Status Effect on Physical, Psychological, and Emotional Aspects of Patient and Family

AD has a significant physical, psychological, and emotional impact on patient and their families. The patient is at risk of developing perceptual-motor problems which cause disturbances in ambulation, gait, balance, and motor coordination. This increases the risk of falls and fractures (Grabher, 2018). Besides, the difficulties in performing ADLs cause self-care deficits in bathing, dressing, and toileting. If the skin is not properly cleaned or dried, it can cause skin conditions due to impaired skin integrity. Self-care deficit in feeding can also cause nutrition deficiency and dehydration because of inadequate dietary intake (Grabher, 2018). The limited ability to perform ADLs and cognitive decline in AD patients cause psychological distress, which increases the risk of developing depression and anxiety disorders. Therefore, Mr. M’s aggression and agitation can be linked to cognitive decline.

The family of Mr. M may be required to help him with ADLs, which causes physical exhaustion and burnout, especially if they have not been trained to care for an AD patient. Besides, they may develop psychological distress that progresses to depression or anxiety when they see their loved one lose his independence (Grabher, 2018). Exhaustion and burnout also increase psychological distress. Furthermore, Mr. M’s care will require financial resources if the family hires a caregiver or takes him to a nursing home. The financial drain caused by the care of AD patients adversely affects the patient’s and family’s emotional well-being.

Interventions for Support

Mr. M can be supported through supportive psychotherapy, where he gets a platform to talk about how his thoughts and feelings affect his mood and behavior. For instance, he can be started on group psychotherapy for persons with dementia, which improves depression and anxiety symptoms and interpersonal functioning. Supportive psychotherapy can also help Mr. M understand his life situation’s reality, including his limitations and what he can and cannot achieve. Mr. M’s family can be supported through caregiver training to educate them on how to provide care to their loved ones at home and avoid burnout (Simpson et al., 2018). Besides, the family can be introduced to social support groups for AD caregivers, where they interact with other families and learn how to cope.

Actual/Potential Problems

Mr. M’s actual problems include impaired memory caused by the AD disease process and chemical imbalances in the brain. He also has self-care deficits in bathing, dressing, and feeding caused by impairment in neuromuscular and cognitive functioning (Breijyeh & Karaman, 2020). In addition, the patient has confusion with a reduced ability to interpret his environment caused by the AD disease process. The patient has a risk for injury due to confusion, disorientation, and impaired decision-making.

Conclusion

Mr. M has clinical features of memory loss, confusion, disorientation, and aggression, which are consistent with Alzheimer’s disease making it the primary diagnosis. The secondary diagnosis is ABU since urinalysis results suggest a UTI, but the patient has no symptoms. AD affects the patient’s and family’s physical, psychological, and emotional well-being, increasing the risk of depression and anxiety disorders. The patient and family can be supported through psychotherapy, training on caregiving, and social support groups.

References

Breijyeh, Z., & Karaman, R. (2020). Comprehensive Review on Alzheimer’s Disease: Causes and Treatment. Molecules (Basel, Switzerland), 25(24), 5789. https://doi.org/10.3390/molecules25245789

Grabher, B. J. (2018). Alzheimer’s disease and the Effects it has on the Patient and their Family. Journal of Nuclear Medicine Technology, jnmt-118.

Simpson, G. M., Stansbury, K., Wilks, S. E., Pressley, T., Parker, M., & McDougall, G. J., Jr (2018). Support groups for Alzheimer’s caregivers: Creating our own space in uncertain times. Social work in mental health, 16(3), 303–320. https://doi.org/10.1080/15332985.2017.1395780

Tahami Monfared, A. A., Byrnes, M. J., White, L. A., & Zhang, Q. (2022). Alzheimer’s Disease: Epidemiology and Clinical Progression. Neurology and therapy, 11(2), 553–569. https://doi.org/10.1007/s40120-022-00338-8

Yourman, L. C., Kent, T. J., Israni, J. S., Ko, K. J., & Lesser, A. (2020). Association of dementia diagnosis with urinary tract infection in the emergency department. Journal of the American College of Emergency Physicians open, 1(6), 1291–1296. https://doi.org/10.1002/emp2.12268

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Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

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Rubric Criteria

Total120 points

Criterion	1. Unsatisfactory	2. Less Than Satisfactory	3. Satisfactory	4. Good	5. Excellent
Clinical Manifestations of Mr. C. Clinical Manifestations of Mr. C.	0 points Clinical manifestations are omitted.	9 points Clinical manifestations are partially presented. There are major omissions and inaccuracies.	9.48 points Clinical manifestations are summarized. An overview of the general symptoms is presented. Some findings are incomplete.	10.68 points Subjective and objective clinical manifestations are described. Overall, the clinical manifestations are accurate and reflect observed and perceived signs and symptoms.	12 points Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms.
Staging and Contributing Factors of End-Stage Renal Disease (ESRD) Staging and Contributing Factors of End-Stage Renal Disease (ESRD)	0 points Staging and contributing factors for ESRD are omitted or inaccurate.	9 points Staging of ESRD is partially summarized. The contributing factors for ESRD are vague. There are inaccuracies.	9.48 points The staging of ESRD and the contributing factors for ESRD are generally explained. Some information is required; there are minor inaccuracies.	10.68 points The staging of ESRD and the contributing factors for ESRD are explained. Some information or detail is needed for clarity or detail.	12 points The staging of ESRD and the contributing factors for ESRD are explained. The information is accurate and reflects contemporary practice and research.
Paper Format (use of appropriate style for the major and assignment) Paper Format (use of appropriate style for the major and assignment)	0 points Template is not used appropriately, or documentation format is rarely followed correctly.	1.8 points Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.	1.9 points Appropriate template is used. Formatting is correct, although some minor errors may be present.	2.14 points Appropriate template is fully used. There are virtually no errors in formatting style.	2.4 points All format elements are correct.
Potential Health Risks for Obesity and Bariatric Surgery Potential Health Risks for Obesity and Bariatric Surgery	0 points Potential health risks for obesity and whether bariatric surgery is an appropriate intervention are not discussed.	9 points A partial summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are major inaccuracies. More information is needed. No evidence or rationale is provided to support discussion.	9.48 points A summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are some inaccuracies. More evidence or rationale is needed to support discussion.	10.68 points A discussion on the potential health risks for obesity is presented. A discussion on whether bariatric surgery is an appropriate intervention is presented but needs some evidence or rationale for support.	12 points A detailed discussion of the potential health risks for obesity is presented. A through and compelling discussion on whether bariatric surgery is an appropriate intervention is presented. The discussion is well-developed and supported by evidence and additional rationale.
Argument Logic and Construction Argument Logic and Construction	0 points Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.	4.5 points Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.	4.74 points Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.	5.34 points Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.	6 points Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach	0 points Types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, are not discussed.	13.5 points An incomplete explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are major inaccuracies.	14.22 points A general explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are minor inaccuracies. Some additional information is required.	16.02 points An explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. Some detail is required for clarity.	18 points A clear and detailed explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. The explanation demonstrates insight into both resources and multidisciplinary approaches for nonacute care for ESRD patients.
Documentation of Sources Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)	0 points Sources are not documented.	2.7 points Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.	2.84 points Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.	3.2 points Sources are documented, as appropriate to assignment and style, and format is mostly correct.	3.6 points Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Functional Health Patterns Functional Health Patterns	0 points Actual or potential problems based on the assessment of functional health patterns of the patient are omitted or are irrelevant for the patient and his condition. The overall criteria for this assignment are not met.	13.5 points At least four actual or potential problems identified from the functional health patterns are presented. The identified problems are not entirely relevant for the patient and his condition. Rationale or evidence is required for support.	14.22 points At least five actual or potential problems identified from the functional health patterns are summarized. The identified problems are generally relevant for the patient and his condition. Some rationale and evidence is required for support.	16.02 points Five or more actual or potential problems identified from the functional health patterns are discussed. The identified problems are relevant for the patient and his condition. Overall, the discussion is supported by rationale and evidence. Some detail is needed for clarity or accuracy.	18 points Five or more actual or potential problems identified from the functional health patterns are discussed. The discussion is insightful, and the identified problems are highly relevant for the patient and his condition. The discussion is well-supported by rationale and evidence.
Mechanics of Writing (includes spelling, punctuation, grammar, language use) Mechanics of Writing (includes spelling, punctuation, grammar, language use)	0 points Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.	4.5 points Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.	4.74 points Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.	5.34 points Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.	6 points Writer is clearly in command of standard, written, academic English.
Health Promotion and Prevention for ESRD Health Promotion and Prevention for ESRD	0 points Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is omitted.	18 points Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is partially summarized. There are inaccuracies. Some aspects are not relevant for the patient and his health status.	18.96 points Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is generally described. There are minor inaccuracies. Overall, the proposed items are relevant for the patient and his health status. Some evidence and rationale are needed to support the discussion.	21.36 points Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is described. The proposed items are relevant and appropriate for the patient and his health status. Evidence and rationale generally support the discussion.	24 points Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is thoroughly described. The proposed items are clearly presented and highly relevant and supportive of patient and his health status. Strong evidence and rationale generally support the discussion.
Thesis Development and Purpose Thesis Development and Purpose	0 points Paper lacks any discernible overall purpose or organizing claim.	4.5 points Thesis is insufficiently developed or vague. Purpose is not clear.	4.74 points Thesis is apparent and appropriate to purpose.	5.34 points Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.	6 points Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Criterion

1. Unsatisfactory

2. Less Than Satisfactory

3. Satisfactory

4. Good

5. Excellent

Clinical Manifestations of Mr. C.

Clinical Manifestations of Mr. C.

0 points

Clinical manifestations are omitted.

9 points

Clinical manifestations are partially presented. There are major omissions and inaccuracies.

9.48 points

Clinical manifestations are summarized. An overview of the general symptoms is presented. Some findings are incomplete.

10.68 points

Subjective and objective clinical manifestations are described. Overall, the clinical manifestations are accurate and reflect observed and perceived signs and symptoms.

12 points

Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms.

Staging and Contributing Factors of End-Stage Renal Disease (ESRD)

Staging and Contributing Factors of End-Stage Renal Disease (ESRD)

0 points

Staging and contributing factors for ESRD are omitted or inaccurate.

9 points

Staging of ESRD is partially summarized. The contributing factors for ESRD are vague. There are inaccuracies.

9.48 points

The staging of ESRD and the contributing factors for ESRD are generally explained. Some information is required; there are minor inaccuracies.

10.68 points

The staging of ESRD and the contributing factors for ESRD are explained. Some information or detail is needed for clarity or detail.

12 points

The staging of ESRD and the contributing factors for ESRD are explained. The information is accurate and reflects contemporary practice and research.

Paper Format (use of appropriate style for the major and assignment)

Paper Format (use of appropriate style for the major and assignment)

0 points

Template is not used appropriately, or documentation format is rarely followed correctly.

1.8 points

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

1.9 points

Appropriate template is used. Formatting is correct, although some minor errors may be present.

2.14 points

Appropriate template is fully used. There are virtually no errors in formatting style.

2.4 points

All format elements are correct.

Potential Health Risks for Obesity and Bariatric Surgery

Potential Health Risks for Obesity and Bariatric Surgery

0 points

Potential health risks for obesity and whether bariatric surgery is an appropriate intervention are not discussed.

9 points

A partial summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are major inaccuracies. More information is needed. No evidence or rationale is provided to support discussion.

9.48 points

A summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are some inaccuracies. More evidence or rationale is needed to support discussion.

10.68 points

A discussion on the potential health risks for obesity is presented. A discussion on whether bariatric surgery is an appropriate intervention is presented but needs some evidence or rationale for support.

12 points

A detailed discussion of the potential health risks for obesity is presented. A through and compelling discussion on whether bariatric surgery is an appropriate intervention is presented. The discussion is well-developed and supported by evidence and additional rationale.

Argument Logic and Construction

Argument Logic and Construction

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

4.5 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

4.74 points

Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

5.34 points

Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

6 points

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach

Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach

0 points

Types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, are not discussed.

13.5 points

An incomplete explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are major inaccuracies.

14.22 points

A general explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are minor inaccuracies. Some additional information is required.

16.02 points

An explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. Some detail is required for clarity.

18 points

A clear and detailed explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. The explanation demonstrates insight into both resources and multidisciplinary approaches for nonacute care for ESRD patients.

Documentation of Sources

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

0 points

Sources are not documented.

2.7 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

2.84 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

3.2 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3.6 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Functional Health Patterns

Functional Health Patterns

0 points

Actual or potential problems based on the assessment of functional health patterns of the patient are omitted or are irrelevant for the patient and his condition. The overall criteria for this assignment are not met.

13.5 points

At least four actual or potential problems identified from the functional health patterns are presented. The identified problems are not entirely relevant for the patient and his condition. Rationale or evidence is required for support.

14.22 points

At least five actual or potential problems identified from the functional health patterns are summarized. The identified problems are generally relevant for the patient and his condition. Some rationale and evidence is required for support.

16.02 points

Five or more actual or potential problems identified from the functional health patterns are discussed. The identified problems are relevant for the patient and his condition. Overall, the discussion is supported by rationale and evidence. Some detail is needed for clarity or accuracy.

18 points

Five or more actual or potential problems identified from the functional health patterns are discussed. The discussion is insightful, and the identified problems are highly relevant for the patient and his condition. The discussion is well-supported by rationale and evidence.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

4.5 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

4.74 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

5.34 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

6 points

Writer is clearly in command of standard, written, academic English.

Health Promotion and Prevention for ESRD

Health Promotion and Prevention for ESRD

0 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is omitted.

18 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is partially summarized. There are inaccuracies. Some aspects are not relevant for the patient and his health status.

18.96 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is generally described. There are minor inaccuracies. Overall, the proposed items are relevant for the patient and his health status. Some evidence and rationale are needed to support the discussion.

21.36 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is described. The proposed items are relevant and appropriate for the patient and his health status. Evidence and rationale generally support the discussion.

24 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is thoroughly described. The proposed items are clearly presented and highly relevant and supportive of patient and his health status. Strong evidence and rationale generally support the discussion.

Thesis Development and Purpose

Thesis Development and Purpose

0 points

Paper lacks any discernible overall purpose or organizing claim.

4.5 points

Thesis is insufficiently developed or vague. Purpose is not clear.

4.74 points

Thesis is apparent and appropriate to purpose.

5.34 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

6 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.