COPD across four visits in MN610 Unit 3: exacerbations, inhaler technique, a cost barrier and a GOLD 2025 regrouping in one composite patient, each visit's plan setting up the next. Searches like "mn 610 unit 3 assignment example", "mn610 unit 3 sample" and "mn610 unit 3 example" land here.
Ten Months of COPD Care in Four Visits: From a First Exacerbation to a Stable Review
[Student Name]
Purdue University Global
MN610: NP III Clinical - Primary Care Focus
Unit 3 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Inhaler regimens and dates are bracketed composites; nothing here is a prescribing instruction.
Portrait
A composite 64-year-old woman, a retired school cafeteria manager, was diagnosed with COPD six years ago. Her smoking history is 35 pack-years; she stopped four years ago after a hospital stay for pneumonia. She lives with her husband in a small town forty minutes from the nearest pulmonary rehabilitation program, and she no longer drives on the highway. Her insurance is a Medicare Advantage plan with tiered inhaler coverage.
Summary Table
CAT score by visit: 22, 18, 24, 14.
Moderate or severe exacerbations in the preceding year, by visit: 1, 1, 2, 2.
FEV1: 58 percent predicted on spirometry at visit two, with a post-bronchodilator FEV1/FVC of 0.58.
Regimen by visit: [short-acting bronchodilator only]; [LABA and LAMA combination]; [triple therapy, one brand]; [triple therapy, plan-covered alternative].
Visit 1, [Date]: After the First Exacerbation
Interval events: an exacerbation two weeks earlier, treated in urgent care with [a short oral corticosteroid course and an antibiotic], without hospitalization. Findings: CAT 22 (Jones et al., 2009); breathless walking to the mailbox; oxygen saturation 94 percent at rest; scattered wheeze. She uses a short-acting inhaler only, several times a day.
Assessment: COPD, GOLD group B under the 2025 report, with high symptom burden and one moderate exacerbation in the past year (Global Initiative for Chronic Obstructive Lung Disease, 2025). No spirometry on file for three years.
Plan: start [a LABA and LAMA combination inhaler]. Book spirometry for visit two, because her last result is too old to grade her airflow limitation. Pulmonary rehabilitation referral placed. Purpose of the next visit: spirometry and a first check of inhaler use.
Visit 2, [Date]: Technique and Transport
Interval events: no exacerbation. CAT 18. Spirometry: FEV1 58 percent predicted, confirming moderate airflow limitation.
When asked to show how she uses her inhaler, she exhaled into the device, inhaled too quickly and did not hold her breath, errors that direct observation found and her own description had not. Inhaler mishandling is common in practice and is associated with poorer disease control (Melani et al., 2011). She was taught with teach-back and a spacer was discussed for her rescue inhaler.
The rehabilitation referral had not been used. She said she had no way to get there three times a week. Pulmonary rehabilitation improves breathlessness, exercise capacity and quality of life in COPD (McCarthy et al., 2015), so the barrier was recorded as a clinical problem, not a preference.
Plan: continue the LABA and LAMA. Ask the rehabilitation program about home-based options. Purpose of the next visit: repeat the technique check.
Visit 3, [Date]: The Second Exacerbation
Interval events: a second exacerbation three weeks earlier, again treated as an outpatient with oral corticosteroids. CAT 24. Blood eosinophils 320 cells per microliter. Technique on direct observation now correct.
Assessment: two moderate exacerbations in the past year, which places her in GOLD group E under the 2025 report (Global Initiative for Chronic Obstructive Lung Disease, 2025). The report supports adding an inhaled corticosteroid in group E patients on dual bronchodilators with blood eosinophils of 300 or more.
Plan: escalate to [triple therapy in a single inhaler]. Check the price with her pharmacy before she leaves. Purpose of the next visit: response to escalation and a review of cost.
Visit 4, [Date]: Stable, With a Substitution
Interval events: no exacerbation for three months. CAT 14. She reports that the triple inhaler prescribed at visit three cost [a composite copay] a month, which she could not afford, and she had been using it every other day to make it last.
Assessment: stable COPD, group E by history, with symptoms improved. Cost had become a cause of nonadherence.
Plan: switch to [a plan-covered triple therapy alternative], which contains the same drug classes, after checking her plan's formulary with the pharmacist. Retrain on the new device with teach-back. Pulmonary rehabilitation: the program now offers a home-based option by video, and she agreed to try it. Purpose of the next visit: confirm daily use of the new inhaler and her start in the home program.
What Was Considered and Not Done
At visit one, an inhaled corticosteroid was considered and not started, because she had only one moderate exacerbation and no eosinophil count on file; the report reserves that step for patients with more exacerbations or higher eosinophils. At visit three, a macrolide for exacerbation prevention was considered and set aside for now, because she was newly escalated to triple therapy and adding a second new drug at the same visit would have made it impossible to judge either. It remains an option if exacerbations continue. Home oxygen was not indicated, since her resting saturation stayed at 93 percent or above at every visit. A referral to pulmonology was discussed at visit three and offered again at visit four; she preferred to continue in primary care while stable, and the plan names two further exacerbations in a year as the point at which she would be referred.
Vaccination was reviewed at visit one: she had received influenza and pneumococcal vaccines, and an RSV vaccine was given at visit two after discussion. Each of these small decisions was recorded with its reason, so that the next clinician can see what was weighed rather than assume it was forgotten.
Discussion
The escalation at visit three followed directly from the report's group definitions: a second moderate exacerbation moved her from group B to group E, and her eosinophil count met the threshold for adding an inhaled corticosteroid (Global Initiative for Chronic Obstructive Lung Disease, 2025). The substitution at visit four was driven by cost, which the case treats as clinical data. A regimen she could not afford was a regimen she was not taking, and her apparent stability on alternate-day dosing could have hidden a gap in protection.
Two lessons stand out. First, writing each plan forward, with a named purpose for the next visit, meant that spirometry, technique checks and cost reviews happened when they were needed rather than when someone remembered. Second, the problems that most affected her care, inhaler technique, transport and cost, were not visible in her symptom scores. They were found only by watching her use the inhaler, asking how she would get to rehabilitation and asking what she paid.
Rehabilitation, still never attended, is the last item named. The home-based program is the next attempt, with a check on her first session set for [date].
References
Global Initiative for Chronic Obstructive Lung Disease. (2025). Global strategy for prevention, diagnosis and management of COPD: 2025 report. Global Initiative for Chronic Obstructive Lung Disease.
Jones, P. W., Harding, G., Berry, P., Wiklund, I., Chen, W.-H., & Kline Leidy, N. (2009). Development and first validation of the COPD Assessment Test. European Respiratory Journal, 34(3), 648-654. https://doi.org/10.1183/09031936.00102509
McCarthy, B., Casey, D., Devane, D., Murphy, K., Murphy, E., & Lacasse, Y. (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2015(4), CD003793. https://doi.org/10.1002/14651858.CD003793.pub3
Melani, A. S., Bonavia, M., Cilenti, V., Cinti, C., Lodi, M., Martucci, P., Serra, M., Scichilone, N., Sestini, P., Aliani, M., & Neri, M. (2011). Inhaler mishandling remains common in real life and is associated with reduced disease control. Respiratory Medicine, 105(6), 930-938. https://doi.org/10.1016/j.rmed.2011.01.005
How this MN610 Unit 3 example is structured
The case study opens with a one-paragraph portrait: year of diagnosis, pack-years, current status as a former smoker, work, and the fact that she lives forty minutes from the nearest rehabilitation program. The summary table follows, letting a reader take in the arc before the details. Each visit section then runs the same way: interval events, focused findings, an assessment stating her GOLD group and symptom burden at that point, and a plan with a stated purpose for the next visit. Plans are written forward, so visit one books the spirometry that visit two needs, and visit two sets the technique check that visit three repeats. The discussion explains the escalation at visit three and the cost-driven substitution at visit four, citing GOLD 2025 for the group definitions. Rehabilitation, still never attended, is the last item named, with the next attempt set beside it.
Get an MN610 Unit 3 example written to your instructions
Upload the Unit 3 case material, every visit your MN610 instructor released included, plus the assignment instructions and their rubric. On that first request a case study comes back free within 24-48h, laying a summary table across the visits, pointing each plan at the next appointment, stating the classification at every stage, and treating any constraint in the case as clinical data. 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 3 questions, answered
How many visits should a chronic disease case study cover?
Every visit the case supplies, and usually at least three, since fewer rarely shows a trend. If your instructor supplies only one encounter and asks you to project forward, label the later visits as projected and keep their values bracketed. The grader is looking for a condition changing over time and a plan that changes with it.
Which reference should a COPD case study cite?
The current GOLD report is the usual source for classification and escalation, and many sections expect the edition year in the citation. If your case involves a different condition, use that condition's main national guideline instead. Either way, cite the specific definition or recommendation behind each decision rather than the document as a whole.
How should nonadherence be handled in the write-up?
Describe the behavior and its cause before labeling it. Cost, transport, technique and side effects each call for a different response, and a study that records the cause can show a plan that addresses it. Calling a patient noncompliant without that detail usually loses marks, because it ends the inquiry the case exists to open.