Health maintenance for a composite 77-year-old with Parkinson disease in MN610 Unit 9: screens retired, vaccines reconciled, falls prevention first, and each item placed on one of three visits. Searches like "mn 610 unit 9 assignment example", "mn610 unit 9 sample" and "mn610 unit 9 example" land here.
Health Maintenance at 77 With Parkinson Disease: Falls First, Two Screens Retired, Three Visits
[Student Name]
Purdue University Global
MN610: NP III Clinical - Primary Care Focus
Unit 9 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Recommendations should be checked against the current editions before use; orders are bracketed composites.
Visit Summary
A composite 77-year-old man with Parkinson disease for six years is seen for a review of his [carbidopa-levodopa] timing, since his wife reports stiffness returning before each dose. That review takes most of today's appointment. He and his wife share a house with stairs to the bedrooms; he walks daily with a cane and had two falls in the past year, one on the stairs. He smoked for 20 years and quit at 45. The prevention work below is fitted around the Parkinson review rather than competing with it.
Prevention Table, Ordered by Expected Benefit for Him
Falls prevention. Source: USPSTF 2024, exercise interventions for community-dwelling adults 65 and older at increased risk of falls; grade B (US Preventive Services Task Force, 2024). Applied: two falls in a year, Parkinson disease, a cane; clearly at increased risk. Decision: start. Physical therapy referral for gait, balance and strength today; home safety review; review of any drugs that lower blood pressure on standing.
Influenza, pneumococcal, zoster and RSV vaccines. Source: CDC adult immunization schedule, current edition, checked on [date] (Centers for Disease Control and Prevention, n.d.). Applied: influenza due this season; pneumococcal conjugate vaccine not recorded; recombinant zoster, one dose of two given; RSV, not given, and recommended at his age. Decision: start; influenza today, the others spread across visits.
Colorectal cancer screening. Source: USPSTF 2021; for adults 76 to 85, the decision to screen should be selective, based on overall health, prior screening and preference; grade C (US Preventive Services Task Force, 2021). Applied: last colonoscopy at 68 was normal; he has a progressive neurologic disease and a limited tolerance for bowel preparation. Decision: discuss. He and his wife will decide at visit two.
Prostate cancer screening. Source: USPSTF 2018, recommending against PSA-based screening in men 70 and older; grade D (US Preventive Services Task Force, 2018). Applied: 77. Decision: stop. A screen that is retired needs its reason recorded as carefully as one that is started, or it will be reordered by habit.
Abdominal aortic aneurysm screening. Source: USPSTF 2019, one-time ultrasound for men 65 to 75 who have ever smoked; grade B (US Preventive Services Task Force, 2019). Applied: he smoked for 20 years and was never screened; at 77 he is now outside the recommended age band. Decision: stop, with the missed window recorded. The team discussed whether to screen anyway and chose not to, because he has no symptoms and the recommendation does not extend to his age; the note explains this so the question is not reopened without reason.
Blood pressure. Checked today, 128/76 sitting and 112/70 standing, with lightheadedness on standing. Decision: continue monitoring; orthostatic drop recorded and linked to the falls plan.
Hepatitis C. Source: USPSTF 2020, one-time screening for adults 18 to 79; grade B (US Preventive Services Task Force, 2020). Applied: 77, no record of testing. Decision: start; antibody test drawn with his visit-two labs.
Items Considered and Not Added
Lung cancer screening: he quit smoking 32 years ago, outside the 15-year window in the 2021 recommendation, so he is not eligible. Diabetes screening: the 2021 recommendation covers adults 35 to 70, and his last A1C, drawn for another reason, was normal. Starting a statin for primary prevention: the evidence for adults 76 and older was judged insufficient in the 2022 recommendation, and his priorities center on falls and function; this was noted as a possible topic if he raises it. Each item is recorded so that its absence reads as a decision, not an oversight.
Schedule Across Three Visits
Visit one, today: Parkinson medication review; physical therapy referral; influenza vaccine; orthostatic blood pressure recorded. Visit two, in four weeks: review of physical therapy start and falls; pneumococcal vaccine; hepatitis C antibody; colorectal screening discussion with his wife present. Visit three, in three months: RSV vaccine; second zoster dose if not given at the pharmacy; review of home safety changes.
The order follows expected benefit and what can be done without crowding the Parkinson review. Falls are addressed first because they are his most likely source of serious injury in the coming year. Vaccines are spread out to limit side effects on any one day and to keep each visit's focus clear.
His Priorities
When the list was read to him, he said his priority is not falling again, "especially on the stairs," and that he would rather not have another colonoscopy. His wife wants the vaccines done before winter. Both priorities fit the order above. The plan will be reviewed at each visit against those two priorities, and if his Parkinson symptoms change enough to crowd out prevention at any visit, the vaccines move first and the discussions wait, since the vaccines are time-sensitive before winter and the discussions are not.
References
Centers for Disease Control and Prevention. (n.d.). Adult immunization schedule by age. Centers for Disease Control and Prevention.
US Preventive Services Task Force. (2018). Screening for prostate cancer: US Preventive Services Task Force recommendation statement. JAMA, 319(18), 1901-1913. https://doi.org/10.1001/jama.2018.3710
US Preventive Services Task Force. (2019). Screening for abdominal aortic aneurysm: US Preventive Services Task Force recommendation statement. JAMA, 322(22), 2211-2218. https://doi.org/10.1001/jama.2019.18928
US Preventive Services Task Force. (2020). Screening for hepatitis C virus infection in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA, 323(10), 970-975. https://doi.org/10.1001/jama.2020.1123
US Preventive Services Task Force. (2021). Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA, 325(19), 1965-1977. https://doi.org/10.1001/jama.2021.6238
US Preventive Services Task Force. (2024). Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA, 332(1), 51-57. https://doi.org/10.1001/jama.2024.8481
How this MN610 Unit 9 example is structured
The plan opens by stating what the visit is for, so prevention is visibly fitted around the Parkinson review rather than competing with it. Next comes the table, ordered by expected benefit for this patient rather than by category, which puts falls ahead of cancer screening. Each row names the source, year and population, applies it to him in one line, and gives a decision. Stop rows carry the same detail as start rows, because retiring a screen is a decision that needs its own reason. One row records that abdominal aortic aneurysm screening, which the 2019 statement limits to men 65 to 75 who ever smoked, was never done and now falls outside that band. The schedule then assigns each item to today, the next visit or the one after, explaining the order. A final line records his own priorities among the items.
Get an MN610 Unit 9 example written to your instructions
Tell us the Unit 9 scenario your MN610 instructor posted, the patient's age and conditions, and the rubric. The plan costs nothing on a first request and lands within 24-48h, fitting prevention around the visit's main purpose, sourcing every stopped screen as clearly as every started one, and spreading what remains across a realistic run of visits. 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 9 questions, answered
When should screening stop in older adults?
When the recommendation's age band ends, or when life expectancy and preference make benefit unlikely. The Task Force sets upper limits for several screens, and some become individual decisions beyond a certain age. The plan should cite the specific statement for each stop and record that the decision was discussed rather than simply dropped.
Can prevention be spread over several visits?
Yes, and in a crowded visit it usually should be. Assign each item to a visit with a reason for the order, such as doing the most protective intervention first. A plan that crams every vaccine and screen into one appointment alongside a complex medication review is less realistic, and graders at this level tend to notice.
Do falls belong in a health maintenance plan?
For older adults, often more than cancer screening does. The Task Force recommends exercise interventions for community-dwelling adults 65 and older at increased risk of falls. If the case gives any reason for elevated risk, such as a neurological condition, prior falls or a change in gait, falls prevention belongs near the top.