Problem by problem for MN610 Unit 2: new urinary symptoms, a falling eGFR, quiet psoriasis and deferred snoring, each on its own line, linked only where evidence links them. Searches like "mn 610 unit 2 assignment example", "mn610 unit 2 sample" and "mn610 unit 2 example" land here.
Multi-Problem Visit Note: Nocturia, a Falling eGFR, Stable Psoriasis and Snoring in a 67-Year-Old Man
[Student Name]
Purdue University Global
MN610: NP III Clinical - Primary Care Focus
Unit 2 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Orders are bracketed composites; nothing here is a prescribing instruction.
Shared Header
Vital signs: blood pressure 136/82, heart rate 72, weight 88 kg, BMI 29. Allergies: none known. Medications, reconciled today: [lisinopril at a composite dose]; [a topical corticosteroid] to elbows as needed; [diphenhydramine] 25 to 50 mg nightly for sleep, over the counter, taken for about four months.
Problem 1: Lower Urinary Tract Symptoms
S: Two months of waking three times a night to urinate, a weak stream and hesitancy. No dysuria, hematuria, fever or flank pain. AUA Symptom Index 18, in the moderate range, recorded at this first evaluation as the AUA guideline advises (Lerner et al., 2021). O: Prostate smooth, symmetric and enlarged on digital rectal exam, without nodules. Bladder scan post-void residual 180 mL. Urinalysis negative for blood and infection. A: Lower urinary tract symptoms, most likely from benign prostatic hyperplasia, with incomplete emptying. The nightly diphenhydramine is a likely contributor, because first-generation antihistamines are anticholinergic and can impair bladder emptying in older men (American Geriatrics Society Beers Criteria Update Expert Panel, 2023). Certainty: moderate. P: Stop diphenhydramine; discuss other approaches to sleep, starting with a fixed wake time and no fluids for two hours before bed, which may also reduce the nocturia. He was told that stopping the antihistamine may make sleep worse for a week or two before it improves. [Repeat post-void residual in four weeks.] Consider [an alpha blocker at a composite dose] if symptoms persist after stopping the antihistamine. Return precautions: inability to urinate, fever or flank pain.
Problem 2: Kidney Function
S: No symptoms. O: eGFR 52 a year ago, 44 today; creatinine rising accordingly. Urine albumin-to-creatinine ratio pending. A: Chronic kidney disease, G3b by eGFR, with albuminuria category pending, under the KDIGO 2024 guideline (Stevens et al., 2024). Cause uncertain; obstruction from incomplete bladder emptying must be excluded. Certainty: stage certain, cause uncertain. P: [Renal ultrasound] to look for hydronephrosis. Repeat basic metabolic panel in four weeks, after stopping the antihistamine. Avoid NSAIDs; he was advised to use acetaminophen for aches.
Problem 3: Plaque Psoriasis
Stable on the topical corticosteroid, used about twice a week. Plaques on both elbows smaller than at the last visit. No joint pain. Status: controlled. Continue. He was reminded to use the steroid only on active plaques to limit skin thinning.
Problem 4: Snoring
His wife reports loud snoring and pauses in his breathing at night. He has daytime sleepiness, which he attributes to waking to urinate. Deferred to a dedicated visit on [date], because today's time went to the urinary and kidney problems and a sleep evaluation needs its own history and questionnaire. Reason for deferral recorded; he agreed, and a sleep questionnaire was given to complete with his wife before that visit.
Linking Paragraph
Problems one and two may share a cause. A post-void residual of 180 mL raises the possibility that incomplete emptying, worsened by an anticholinergic drug, is affecting the kidneys. The ultrasound and the repeat creatinine after stopping diphenhydramine test that link. If the ultrasound shows no hydronephrosis and kidney function does not improve, the eGFR decline will be evaluated on its own terms, starting with the albuminuria result. The snoring may also connect to his nighttime waking, since sleep apnea can increase nighttime urination, but the note does not draw that link until the sleep evaluation is done.
References
American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372
Lerner, L. B., McVary, K. T., Barry, M. J., Bixler, B. R., Dahm, P., Das, A. K., Gandhi, M. C., Kaplan, S. A., Kohler, T. S., Martin, L., Parsons, J. K., Roehrborn, C. G., Stoffel, J. T., Welliver, C., & Wilt, T. J. (2021). Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part I, initial work-up and medical management. Journal of Urology, 206(4), 806-817. https://doi.org/10.1097/JU.0000000000002183
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., Lamb, E., Lin, P., Madero, M., McIntyre, N., Morrow, K., Roberts, G., Sabanayagam, D., Schaeffner, E., Shlipak, M., ... Levin, A. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International, 105(4S), S117-S314. https://doi.org/10.1016/j.kint.2023.10.018
How this MN610 Unit 2 example is structured
A shared header holds what all four problems draw on, vital signs, allergies and one reconciled medication list, so nothing is repeated below it. The problems then follow in the order of today's attention rather than the order he raised them. Each gets a few lines of subjective and objective data, an assessment naming a working diagnosis with its degree of certainty, and a plan with orders written as bracketed composites. Problem one leads because a residual of 180 mL raises the possibility of retention affecting the kidneys. Problem two follows directly, with a renal ultrasound ordered to test that link, and is staged under the KDIGO 2024 CKD guideline. Psoriasis receives two lines and a status word. Snoring comes last with a named reason for deferral and a date. A linking paragraph closes the note, stating the single connection it is prepared to draw.
Get an MN610 Unit 2 example written to your instructions
Attach the Unit 2 case, the documentation template your MN610 instructor requires, and the rubric that scores it. Written to that template, the first note is free and comes back within 24-48h, with one shared header, every active problem given a separate assessment, orders kept as bracketed composites, and a date beside anything deferred. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
MN610 Unit 2 questions, answered
Should each problem get a full SOAP section?
Usually a compact one. Many sections accept a problem-oriented note where each problem carries brief subjective and objective lines, an assessment and a plan, under a shared header for vitals and medications. Repeating a full SOAP scaffold four times makes the note long without making it clearer. Follow your template if it specifies otherwise.
How do I show that two problems might be connected?
State the connection as a hypothesis in its own short paragraph and name the test that will confirm or break it. Keep each problem's assessment independent above that paragraph, so a reader can see what you know about each one before seeing what you suspect about both. Merging them early hides the uncertainty the grader wants to see.
Is it acceptable to address only some problems at one visit?
Yes, and at this level it is expected. Record every active problem, work the urgent ones, and give the rest a status and a date. The note should say why deferral is safe for each deferred item. The version that costs marks is a problem that appears in the history and then vanishes from the plan without comment.