| Course | NS480 Medical Nutrition Therapy I |
|---|---|
| Unit | Unit 6 |
| Paper type | ADIME note |
| Length | About 650 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Nutrition Science |
| Updated | October 2026 |
Free sample paper for NS480 Unit 6
Trays During Dressing Changes: A Unit 6 ADIME Note for a Man With Paraplegia and a Stage 3 Sacral Pressure Injury
[Student Name]
Purdue University Global
NS480: Medical Nutrition Therapy I
Unit 6 ADIME Note
[Instructor Name]
[Date]
The patient and every value are composite; the pressure injury guideline, the spinal cord injury energy study and the care process update cited are real.
Assessment
Patient: M. T., 34-year-old man, T6 complete paraplegia from a fall four years ago, admitted for a stage 3 sacral pressure injury. Uses a manual wheelchair; independent with feeding.
Anthropometrics: height 175 cm, weight 68 kg, usual weight 72 kg three months ago, a 5.6 percent loss. BMI 22.2.
Food and nutrition history: regular diet ordered. Nursing intake records show about 50 percent of breakfast and lunch trays eaten over three days. Patient reports that trays arrive during his twice-daily dressing changes, which take about 40 minutes and require him to lie on his side; by the time he can sit up, food is cold and he eats little. Dinner intake about 90 percent.
Biochemical: no labs specific to nutrition status ordered; glucose and kidney function within normal limits.
Nutrition-focused physical findings: mild loss of muscle at the temples and shoulders; wound bed with granulation tissue, moderate drainage.
Estimated needs: energy 2,040 to 2,380 kcal per day; protein 85 to 102 g per day; fluid about 2,000 mL per day plus wound losses (see rationale).
Diagnosis
Inadequate oral intake related to meal trays arriving during dressing changes, as evidenced by about 50 percent of breakfast and lunch eaten over three days and a 5.6 percent weight loss in three months.
The diagnosis names the timing of the trays as the cause, because the patient eats well when food arrives at a time he can sit up, which points the intervention at the schedule rather than at the menu.
Intervention
1. Coordinate with nursing to schedule dressing changes before trays arrive, or to hold trays warm until he is upright.
2. Add a high-protein oral supplement twice daily between meals, 240 mL each, providing about 20 g protein and 350 kcal per serving.
3. Offer a protein-rich snack at bedtime of his choice.
4. Patient education: link protein intake to wound healing; patient agreed to the supplement and snack plan.
Monitoring and Evaluation
1. Meal intake percentages from nursing records daily for one week; goal 75 percent or more of each meal.
2. Weight twice weekly on the same chair scale; goal stable weight.
3. Wound measurements from the wound care team weekly.
4. Reassess in seven days.
Rationale for Figures
Energy. Energy needs after spinal cord injury are lower than predicted equations suggest because paralyzed muscle uses less energy. In stable rehabilitating patients, measured needs averaged about 27.9 kcal per kilogram for paraplegia (Cox et al., 1985). Pressure injury guidance suggests 30 to 35 kcal per kilogram per day for adults with a pressure injury who are malnourished or at risk (European Pressure Ulcer Advisory Panel et al., 2019). The range 30 to 35 kcal per kilogram was applied to his current weight of 68 kg: 30 times 68 equals 2,040, and 35 times 68 equals 2,380. The lower end was favored because of his reduced muscle mass, with weight monitored to guide changes.
Protein. The same guideline suggests 1.25 to 1.5 g protein per kilogram per day: 1.25 times 68 equals 85 g, and 1.5 times 68 equals 102 g.
Fluid. About 30 mL per kilogram, 30 times 68 equals 2,040 mL, rounded to 2,000 mL, with extra for wound drainage.
Weight loss. 72 minus 68 equals 4 kg; 4 divided by 72 equals 0.056, or 5.6 percent in three months.
Format. The ADIME note follows the four steps of the care process, with the diagnosis written in problem, etiology and signs form (Swan et al., 2017).
References
Cox, S. A. R., Weiss, S. M., Posuniak, E. A., Worthington, P., Prioleau, M., & Heffley, G. (1985). Energy expenditure after spinal cord injury: An evaluation of stable rehabilitating patients. The Journal of Trauma, 25(5), 419-423. https://doi.org/10.1097/00005373-198505000-00008
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, & Pan Pacific Pressure Injury Alliance. (2019). Prevention and treatment of pressure ulcers/injuries: Clinical practice guideline. The international guideline (3rd ed.). EPUAP/NPIAP/PPPIA.
Swan, W. I., Vivanti, A., Hakel-Smith, N. A., Hotson, B., Orrevall, Y., Trostler, N., Beck Howarter, K., & Papoutsakis, C. (2017). Nutrition care process and model update: Toward realizing people-centered care and outcomes management. Journal of the Academy of Nutrition and Dietetics, 117(12), 2003-2014. https://doi.org/10.1016/j.jand.2017.07.015
NS480 Unit 6 instructions, in plain terms
Unit 6 of NS480 asks students to write an ADIME note for a case and a rationale showing where figures came from. Prompts generally expect the note to fit about one page. In the assessment section, record anthropometrics, food history, labs, physical findings and estimated needs. Calculate weight change. Write the diagnosis in problem, etiology and signs form, naming a cause you can act on. List specific interventions, including coordination with other staff. Set monitoring indicators with goals and a reassessment date. On a separate rationale page, show each calculation and cite the sources for energy, protein and fluid. Use standard abbreviations only where accepted. Keep the note concise enough for a busy colleague to read quickly.
How this NS480 Unit 6 example is built
The sample's assessment records the patient's injury level, wheelchair use, weight loss, tray intake and the timing conflict with dressing changes. Physical findings note mild temple and shoulder wasting and the wound bed. Estimated needs appear at the end of the assessment. The diagnosis names inadequate oral intake caused by tray timing, and a highlighted sentence explains why the cause is logistical. Four interventions follow, from coordinating with nursing to a twice-daily supplement and a bedtime snack. Monitoring lists meal percentages, twice-weekly weights and weekly wound measurements. The rationale page shows how the spinal cord injury energy study and the pressure injury guideline were reconciled, with each calculation written out.
Where the points sit in the NS480 Unit 6 rubric
ADIME notes are usually graded on correct format, accuracy of data and calculations, a well-formed diagnosis and practical, measurable interventions. Much of the credit depends on the diagnosis naming the true cause and the intervention addressing it. Instructors check that estimated needs are calculated correctly and sourced. Coordination with nursing and wound care shows realistic practice. Monitoring must include goals and a time frame. Conciseness matters, since notes are working documents. A rationale page that lets a reader verify each figure earns credit. Accepted abbreviations, clear sections and APA 7 references in the rationale complete the rubric. A diagnosis that a nurse could act on without asking questions is a strong sign the note is working.
NS480 Unit 6 help from the desk
The most common ADIME problem is a diagnosis that names a medical condition or a vague cause, such as poor appetite, when the data point to something specific. Others apply standard energy equations without considering reduced needs after spinal cord injury. Interventions focus only on supplements and miss the logistical fix. Monitoring lacks goals or dates. Notes run several pages. Weight change is reported without calculation. Wound details are staged by the dietitian rather than recorded from the wound team. If your case data are ready but the note will not fit one clear page, our team can help you condense it and build the rationale. Another gap is a note with no reassessment date, which leaves the plan open-ended.
Get an NS480 Unit 6 example written to your instructions
ADIME notes in NS480 Unit 6 are built on the case each unit issues, and a few sections prefer SOAP format or the template a facility uses. Hand over the case, the note format required and its rubric. Within 24-48h the note arrives in charting language alongside a rationale page sourcing every figure, and the first custom sample is free. 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.
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NS480 Unit 6 questions, answered
Where do estimated needs belong in an ADIME note?
Most instructors place them at the end of the assessment section, since they are calculated from assessment data, and repeat the goal figures under intervention. Some templates give them a separate line. Whatever your section expects, avoid introducing needs for the first time under intervention, because the reader then cannot see where they came from.
Is charting shorthand acceptable in the note?
Standard abbreviations usually are, provided the facility or course recognizes them, such as kcal, g/kg and PO. Invented shorthand is not. Many sections want the note itself in clipped charting style and any explanation in a separate rationale, so check whether the prompt asks for one document or two before deciding how much to abbreviate.
Should the note include the wound stage and size?
Yes, as assessment data reported by whoever measured it, usually the wound nurse or physician. The note records the measurement and the date; it does not stage the wound on its own authority. Including the size lets monitoring track healing against a starting value, which is the only way the protein goal can be evaluated later.
Where can I find a free NS480 Unit 6 sample paper?
A complete Unit 6 ADIME note is on this page for a man with paraplegia and a stage 3 sacral pressure injury, with a one-page note and a rationale page showing each calculation and source.
Why does the NS480 Unit 6 note focus on tray timing?
The patient ate most of his dinner but only half of breakfast and lunch, which arrived during dressing changes when he had to lie on his side. Fixing the schedule addresses the cause directly, while supplements help close the remaining gap.