After a pneumonia admission, three conflicting medication lists for a composite patient become a single reconciled list in MN610 Unit 4, with every stop, start and continue explained. Searches like "mn 610 unit 4 assignment example", "mn610 unit 4 sample" and "mn610 unit 4 example" land here.
Medication Reconciliation After Pneumonia: Three Lists, Eleven Agents and One Reconciled Record for an 81-Year-Old
[Student Name]
Purdue University Global
MN610: NP III Clinical - Primary Care Focus
Unit 4 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Doses and tapers are bracketed composites; nothing here is a prescribing instruction.
Sources and Their Dates
1. Pill bottles brought to the visit by her son, [date]: the most current record of what she actually has at home.
2. Hospital discharge summary, dated six days ago.
3. Pharmacy fill history, last 90 days, printed today.
A reconciliation is only as current as its oldest list. Discrepancies between hospital and home lists are common after discharge and often involve medicines the patient does not know were changed (Coleman et al., 2005).
Comparison Table, Ordered by Risk
Each row gives the agent, what the bottles, discharge summary and pharmacy show, the discrepancy and its class, and the decision.
1. Oxybutynin. Bottles: yes. Discharge: yes. Pharmacy: yes. Discrepancy: none among the lists, but her son reports new forgetfulness over three months. Class: possible harm. Decision: discuss; replacement deferred.
2. Atorvastatin. Bottles: two bottles, one brand name and one generic, both being taken. Discharge: generic only. Pharmacy: filled under both names from two prescribers. Class: duplicate. Decision: stop the brand-name bottle.
3. Pantoprazole. Bottles: yes, new. Discharge: yes. Pharmacy: filled at discharge. Discrepancy: started in hospital for stress ulcer prophylaxis; no reflux, ulcer or bleeding history. Class: unintended continuation. Decision: stop.
4. Amoxicillin-clavulanate. Bottles: empty. Discharge: listed as active. Pharmacy: seven-day course filled. Discrepancy: course finished two days ago but still printed on the discharge list. Class: unintended continuation. Decision: remove from the list.
5. Amlodipine. Bottles: yes. Discharge: not listed. Pharmacy: filled monthly. Discrepancy: held in hospital for low blood pressure during sepsis; the summary does not say whether to restart. Class: omission. Decision: discuss today with a blood pressure check.
6. Docusate. Bottles: yes, new. Discharge: yes. Pharmacy: over the counter. Discrepancy: started in hospital for opioid-related constipation; the opioid was not continued. Class: unintended continuation. Decision: stop.
7. Lisinopril. All three sources agree. Decision: continue.
8. Metoprolol succinate. All three sources agree. Decision: continue.
9. Levothyroxine. All three sources agree. Decision: continue.
10. Acetaminophen as needed. Bottles and discharge agree. Decision: continue, maximum [composite daily limit].
11. Vitamin D. Bottles only. Decision: continue.
Reconciled List
Continue:
Lisinopril [composite dose], once daily.
Metoprolol succinate [composite dose], once daily.
Levothyroxine [composite dose], once daily, before breakfast.
Atorvastatin, generic, [composite dose], once daily.
Acetaminophen as needed for pain, no more than [composite daily limit].
Vitamin D [composite dose], once daily.
Stop:
Brand-name atorvastatin: duplicate of the generic she also takes.
Pantoprazole: started for stress ulcer prophylaxis in hospital; no ongoing indication. Stopped [with or without a composite taper].
Docusate: started for constipation from a hospital opioid that has been stopped.
Amoxicillin-clavulanate: course complete.
Change:
Amlodipine: blood pressure today 142/78 sitting and 136/74 standing, without dizziness. Restart at [a lower composite dose], with a home blood pressure check in one week.
Discuss:
Oxybutynin: the AGS Beers Criteria list strongly anticholinergic bladder drugs among those to avoid in older people, all the more when memory is failing, since they can deepen confusion (American Geriatrics Society Beers Criteria Update Expert Panel, 2023).
Removals carry the same weight as additions, and each has its reason written beside it, so that no one restarts them by accident. Deprescribing works best when each drug is reviewed for its current indication and its likely harm, one at a time (Scott et al., 2015).
What Was Discussed
With the patient and her son: the four removals and why; the amlodipine restart at a lower dose; and the concern about oxybutynin. She said the pill "really helps" with her urgency and did not want to stop it today. The replacement was deferred to a visit in two weeks, which will include a cognitive screen and a discussion of options for urge incontinence with less effect on memory.
Who Receives the Final List
The patient and her son, printed in large type; her pharmacy, with a request to cancel the brand-name atorvastatin, the pantoprazole and the finished antibiotic from her profile; the home health nurse starting visits this week; and her cardiologist, who prescribed the brand-name statin.
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
Coleman, E. A., Smith, J. D., Raha, D., & Min, S. (2005). Posthospital medication discrepancies: Prevalence and contributing factors. Archives of Internal Medicine, 165(16), 1842-1847. https://doi.org/10.1001/archinte.165.16.1842
Scott, I. A., Hilmer, S. N., Reeve, E., Potter, K., Le Couteur, D., Rigby, D., Gnjidic, D., Del Mar, C. B., Roughead, E. E., Page, A., Jansen, J., & Martin, J. H. (2015). Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Internal Medicine, 175(5), 827-834. https://doi.org/10.1001/jamainternmed.2015.0324
How this MN610 Unit 4 example is structured
The exercise opens with its sources and their dates, since a reconciliation is only as current as its oldest list. The comparison table follows, ordered by risk rather than alphabetically, so the anticholinergic and the duplicate statin sit near the top. Each discrepancy is classified in a word: duplicate, omission, unintended continuation or possible harm. The reconciled list then stands alone, written so a home health nurse or a pharmacist could use it without the table. Removals carry the same weight as additions, each with a sentence of reasoning and, where tapering or monitoring applies, a bracketed composite instruction. A short paragraph records what was discussed with the patient and her son, including one item deferred, the replacement for oxybutynin, to a visit in two weeks that includes a cognitive screen. The document closes by naming who receives the final list.
Get an MN610 Unit 4 example written to your instructions
Send the Unit 4 medication lists or scenario from your MN610 course, with the reconciliation format and rubric. Free as a first sample and ready within 24-48h, the reconciled list keeps the patient composite, compares each source line by line, classifies every discrepancy, and explains each stop as fully as each start. 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 4 questions, answered
Which list should count as the true one?
None of them automatically. The discharge summary reflects the hospital stay, the pharmacy record reflects what was filled, and the bottles reflect what is actually in the home. Reconciliation compares all three, records what the patient really takes, and then decides what she should take. State which source you trusted for each item and why.
How should deprescribing appear in the exercise?
As an active decision with a reason, not as a quiet omission. Each medication stopped should appear in the reconciled list under a stop heading, with the indication that ended or the harm that outweighed it. Where a drug needs tapering, write the taper as a bracketed composite rather than as dosing instructions for a real patient.
Does the Beers Criteria settle whether a drug should stop?
It flags drugs that are potentially inappropriate for older adults; it does not decide for a particular patient. Use it to justify a review and cite the specific entry, then explain the decision you reached for this patient, including when a flagged drug stays because its benefit is clear. Graders look for that judgment beyond the list.