CASE 3: Drooping of Face

Walden University CASE 3: Drooping of Face-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University CASE 3: Drooping of Face assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for CASE 3: Drooping of Face

Whether one passes or fails an academic assignment such as the Walden University CASE 3: Drooping of Face depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for CASE 3: Drooping of Face

The introduction for the Walden University CASE 3: Drooping of Face is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for CASE 3: Drooping of Face

After the introduction, move into the main part of the CASE 3: Drooping of Face assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for CASE 3: Drooping of Face

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for CASE 3: Drooping of Face

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Episodic/Focused SOAP Note: CASE 3: Drooping of Face

Patient Information:

Initials: D.P

Age- 22 years

Sex: Female

Race: African American

CC (chief complaint): “My left side of the mouth slants when I smile.”

HPI: D.P. is a 22-year-old AA female who presents with complaints of the left side of the mouth slanting when she smiles. She first noticed the left-sided slanting today in the morning when she looked in the mirror. D.P. also reports that sh

e has been experiencing some intermittent pounding headaches in the last few days. Besides, she noticed a decreased sense of taste when brushing her teeth in the morning. The face droop and loss of taste had no specific triggering factors, nor have they improved since they started. The client was scared that she could have a stroke which is uncommon at her age.

Current Medications: Albuterol HFA 1-2 puffs during Asthma exacerbations.

Allergies: Allergic to dust mites and pollen. No drug or food allergies.

PMHx: The patient has a history of Asthma since she was six years. She has been admitted thrice due to asthma attacks. The Asthma is controlled, and the last attack was more than five years ago. Her immunization is current; her last TT was in 2019; her last Flu show was in June 2022. No surgical history.

Soc Hx: The patient is an intern at the State Department for Social Protection. She graduated with a degree in Sociology six months ago. She lives with her parents and two younger siblings. Her hobbies include painting and traveling. Her exercise habits include walking to and from work for about 15 minutes which has helped her remain fit. She reports having three meals per day. She drinks 2-3 glasses of vodka on weekends and smokes recreational marijuana. She denies smoking tobacco or using illicit drug substances.

Fam Hx: Her maternal grandmother has HTN and a history of MI. The paternal grandfather had Alzheimer’s dementia. Her parents and siblings are alive and well.

ROS:

CASE 3: Drooping of Face GENERAL: Negative for fever, weight changes, chills, or increased fatigue.

HEENT: Reports left-sided face drooping. Eyes: No changes in vision, excessive tearing, or eye pain. Ears: No ear pain, discharge, or hearing loss. Nose: No rhinorrhea or sneezing. Throat: No sore throat or hoarseness.

SKIN: No rashes, bruises, or itching.

CARDIOVASCULAR: No chest pain, palpitations, dyspnea with activity, or edema.

RESPIRATORY: Negative for breathing difficulties, cough, wheezing, or sputum.

GASTROINTESTINAL: No GI discomfort or altered bowel patterns.

GENITOURINARY: Negative for urinary or vaginal symptoms. LMP-2 weeks ago.

NEUROLOGICAL: Positive for headaches, left-sided facial drooping, muscle weakness, and numbness; a decreased sense of taste. Denies dizziness, syncope, numbness, or tingling sensations.

MUSCULOSKELETAL: No muscle pain, joint pain, stiffness, or limitations in movement.

HEMATOLOGIC: No history of bleeding, anemia, or blood transfusion.

LYMPHATICS: No enlarged nodes.

PSYCHIATRIC: No history of mood or anxiety symptoms.

ENDOCRINOLOGIC: No excessive sweating, cold or heat intolerance, acute thirst, or excessive hunger.

ALLERGIES: Positive history of Asthma.

Physical exam: From head to toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head-to-toe format i.e. General: Head: EENT: etc.

Vital Signs: BP- 110/74; RR-16; HR-92; TEMP-98.4; HT-5’4; WT-130; BMI-22.3

GENERAL: AA female client in her early 20s. The patient is calm, alert, and in no distress but is anxious. She is neat and dressed appropriately. Her speech is logical, with a normal rate and volume.

HEENT: Mask-like face appearance. Limited ability to wrinkle the forehead and smile on the left side. The left side of the face is flat and lacks expressions; Eyes: Reduced ability to tear; Inability to close the left eye; PERRLA. Ears: TMs are patent and shiny. Nose: Patent nostrils; well-aligned nasal septum. Throat: Intact Tonsillar glands.

RESPIRATORY: Uniform chest expansion with smooth unaided respirations. Lungs clear bilaterally.

CARDIOVASCULAR: Regular heart rate and rhythm. S1 and S2 noted. No heart murmurs or gallop sounds.

NEUROLOGICAL: Left-sided facial muscle paralysis. Impaired taste sensation. Normal gait and posture.

Diagnostic results:

MRI- This can help detect facial nerve inflammation and rule out tumors that compress or affect the facial nerve.

Differential Diagnoses

Facial paralysis: This is an acute paralysis of cranial nerve VII. It is characterized by abrupt, unilateral peripheral facial nerve palsy. It involves a drawing sensation and paralysis of all facial muscles on the affected side (Yang & Dalal, 2021). Facial paralysis is a presumptive diagnosis based on the paralysis of the patient’s left side of the face. This has caused face drooping, a mask-like face appearance, and limited ability to wrinkle the forehead and smile on the left side. Besides, the left side of the face is flat and lacks expressions, and the client has a reduced taste sensation, which is characteristic of Facial paralysis.

Ramsay Hunt syndrome: This is a rare manifestation of herpes zoster that affects the 8th cranial nerve ganglia and the geniculate ganglion of the facial cranial nerve. Clinical manifestations include severe ear pain with vesicles in the ear, transient or permanent facial paralysis, vertigo, and hearing loss (Jeon & Lee, 2018). The patient’s left-sided facial paralysis is consistent with Ramsay Hunt syndrome.

Lyme disease: This is a systemic infectious disease caused by Borrelia burgdorferi and occurs following a bite of an infected deer tick. If not treated, a patient progresses to complications like meningitis, facial paralysis, and peripheral neuritis (Shor et al., 2019). The patient’s left-sided facial paralysis makes Lyme disease a differential diagnosis.

Guillain-Barré Syndrome (GBS): This is an acute inflammatory demyelinating polyneuropathy that involves the peripheral nervous system. Demyelination of the peripheral nerves causes progressive motor weakness and sensory abnormalities (Malek & Salameh, 2019). This is a differential diagnosis owing to the patient’s facial muscle paralysis and a diminished sense of taste. However, the patient does not have ascending paralysis, which is characteristic of GBS.

Sarcoidosis: This is a granulomatous disorder of idiopathic cause that affects any organ. It causes isolated facial nerve palsy. This makes sarcoidosis a differential diagnosis due to the patient’s left-sided facial paralysis.

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

Jeon, Y., & Lee, H. (2018). Ramsay Hunt syndrome. Journal of dental anesthesia and pain medicine, 18(6), 333–337. https://doi.org/10.17245/jdapm.2018.18.6.333

Malek, E., & Salameh, J. (2019). Guillain-Barre Syndrome. Seminars in neurology, 39(5), 589–595. https://doi.org/10.1055/s-0039-1693005

Shor, S., Green, C., Szantyr, B., Phillips, S., Liegner, K., Burrascano, J. J., Jr, Bransfield, R., & Maloney, E. L. (2019). Chronic Lyme Disease: An Evidence-Based Definition by the ILADS Working Group. Antibiotics (Basel, Switzerland), 8(4), 269. https://doi.org/10.3390/antibiotics8040269

Yang, A., & Dalal, V. (2021). Bilateral Facial Palsy: A Clinical Approach. Cureus, 13(4), e14671. https://doi.org/10.7759/cureus.14671

Grid View

	Excellent	Good	Fair	Poor
Main Posting	45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	10 (10%) – 10 (10%) Posts main post by day 3.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not post by day 3.
First Response	17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.
Total Points: 100