NU142 Unit 4 Care Plan Example

Course	NU142 Medical-Surgical Nursing I
Unit	Unit 4
Paper type	Care plan
Length	About 860 words, 6 pages double-spaced
Format	APA 7 student paper
School	Purdue University Global
Program	BSN (prelicensure)
Updated	October 2026

Free sample paper for NU142 Unit 4

The Morning After a Wrist Stent: A Care Plan Whose Priorities Follow the Real Risks for a Composite 59-Year-Old Man After Coronary Stenting Through the Radial Artery, From Hand Perfusion to Two Antiplatelet Drugs

[Student Name]

Purdue University Global

NU142: Medical-Surgical Nursing I

Unit 4 Care Plan

[Instructor Name]

[Date]

The patient is composite; values are bracketed where illustrative, and orders and facility protocols govern.

What this part is doingThe priorities follow what can go wrong after the stent, not the problems he had before it, which is the judgment this unit tests.

The Patient

[Mr. E.], a composite 59-year-old delivery driver, came in yesterday with chest pain at rest. An angiogram through his right radial artery found a narrowed left anterior descending artery, and a drug-eluting stent was placed. A compression band was applied to his wrist and gradually loosened over four hours. He has high blood pressure, high cholesterol and smokes a pack a day. This morning: no chest pain, heart rate [72], blood pressure [134/80], creatinine [1.0], unchanged from before the procedure. New medicines: aspirin and ticagrelor, a statin at high intensity, and metoprolol.

Why Radial Access Changes the Priorities

Compared with access through the groin, access through the wrist artery has been associated with less major bleeding and fewer vascular complications (Ferrante et al., 2016). That changes the nursing focus: the large groin hematoma and long bed rest of femoral access are less of a concern, while the specific risks of the wrist, a hematoma in the forearm and reduced blood flow to the hand if the radial artery closes, take their place.

Priority One: Risk for Bleeding and Impaired Hand Perfusion at the Radial Site

Rationale for ranking first: he is on two antiplatelet drugs, the puncture is fresh, and a forearm hematoma can compress nerves and vessels. Outcome: the site remains free of bleeding and swelling, and his right hand stays warm, pink and fully sensate through discharge. Interventions: inspect the site and forearm for swelling or bruising with each vital sign check; compare color, warmth, capillary refill and sensation in both hands; check the radial pulse below the site, accepting that it may be weak if the artery is partly blocked, and report a cold, pale or numb hand at once; teach him not to lift more than [2] kg with that arm for [48] hours; if bleeding occurs, apply firm pressure above the site and call for help (Harding et al., 2023).

The wrist puncture is small, but it sits on top of the only artery that blood thinners make harder to seal.

Priority Two: Risk for Decreased Cardiac Tissue Perfusion

Rationale: a stent can clot, especially in the first days and if antiplatelet drugs are missed. Outcome: he reports no chest pain and his ECG remains stable. Interventions: ask about chest pain or pressure each time vital signs are taken; teach him to report any chest discomfort immediately, not to wait; ensure the first doses of aspirin and ticagrelor are given on time.

Priority Three: Risk for Kidney Injury From Contrast

Rationale: contrast dye can reduce kidney function within two to three days, particularly with dehydration. Outcome: creatinine remains within [0.3] mg/dL of baseline at follow-up. Interventions: encourage oral fluids unless restricted; record intake and output; arrange a repeat creatinine as ordered.

Priority Four: Risk for Ineffective Health Management of Dual Antiplatelet Therapy

Rationale: stopping antiplatelet drugs early is the strongest preventable cause of stent clotting. Outcome: he can state why he takes both drugs, for how long, and that he must not stop either without speaking to his cardiologist. Interventions: teach with his wife present; give a written schedule; explain that other doctors and dentists must be told he has a stent before any procedure; address smoking as part of protecting the stent (Burchum & Rosenthal, 2022).

What this part is doingThe teaching priority is ranked as a real risk, because nonadherence after discharge threatens the stent as much as anything in hospital.

Discharge Readiness

Because he wants to leave today, the plan sets clear conditions for discharge and checks each one rather than assuming readiness. His radial site must be dry and soft with a warm hand for at least four hours after the band is removed. He must have taken both antiplatelet drugs and have a prescription he can fill on the way home; a gap of even a day or two in the first weeks is dangerous, so the nurse confirms with him that the pharmacy has ticagrelor in stock. He must know whom to call for wrist swelling, a numb hand, chest pain or bleeding that does not stop. His work is a factor too: he drives a delivery truck and lifts packages, so the plan includes a conversation about when he can return to lifting with his right arm and a note to his employer if he needs one. Each condition is documented as met or not met before the discharge order is carried out.

Evaluation

By midday the site showed no bleeding, his hand was warm with a capillary refill under [2] seconds, and he had no chest pain. He explained in his own words that stopping ticagrelor early could cause the stent to clot, and he accepted a referral to the smoking cessation program. Creatinine follow-up was booked for day three. The plan was revised to add a reminder call from the cardiac rehabilitation nurse in one week.

References

Burchum, J. R., & Rosenthal, L. D. (2022). Lehne's pharmacology for nursing care (11th ed.). Elsevier.

Ferrante, G., Rao, S. V., Jüni, P., Da Costa, B. R., Reimers, B., Condorelli, G., Anzuini, A., Jolly, S. S., Bertrand, O. F., Krucoff, M. W., Windecker, S., & Valgimigli, M. (2016). Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease. JACC: Cardiovascular Interventions, 9(14), 1419-1434. https://doi.org/10.1016/j.jcin.2016.04.014

Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C. (2023). Lewis's medical-surgical nursing: Assessment and management of clinical problems (12th ed.). Elsevier.

NU142 Unit 4 instructions, in plain terms

Unit 4 usually turns to cardiovascular disease and asks for a care plan whose priorities follow the patient's actual risks after treatment, not before it. Prompts commonly want assessment data, ranked nursing diagnoses with rationales for the order, measurable outcomes, interventions with reasons and an evaluation. Instructors look for priorities shaped by the specific procedure, since radial and femoral access carry different risks, and for medication adherence treated as a genuine risk rather than an afterthought. Discharge planning that checks concrete conditions, such as a filled prescription and a dry access site, shows the plan extends beyond the bedside. Evidence supporting key choices, cited properly, strengthens the rationale for each ranked problem.

Inside the NU142 Unit 4 example

The plan opens with the patient, his procedure, his risk factors and new medicines. A section explains how radial access changes the nursing focus, citing a meta-analysis. Priority one covers bleeding and hand perfusion, with checks of both hands and lifting limits, and the highlighted line on why a small puncture still ranks first. Priority two covers stent clotting and chest pain reporting, priority three contrast and the kidneys, and priority four antiplatelet adherence, with a margin note on why teaching ranks as a real risk. A discharge readiness section lists conditions checked before he leaves, including his pharmacy's stock, and the evaluation reports each outcome.

Where the points sit in the NU142 Unit 4 rubric

Care plans in this unit are scored on whether the priorities fit the patient after treatment, the quality of rationales, measurable outcomes and evaluation. Fit earns the most credit when the ranking reflects the procedure performed and the drugs started, not the admitting complaint alone. Rationale points go to explaining why each problem holds its place. Outcomes should be specific and measurable, such as a warm hand with brisk capillary refill. Evaluation is credited when each outcome is checked and the plan revised if needed. Treating medication adherence as a ranked problem, and supporting the plan with sources in APA 7, often marks the strongest submissions. A plan that checks discharge conditions one by one usually scores well on evaluation.

NU142 Unit 4 help from the desk

Cardiac care plans often rank chest pain first because it was the reason for admission, even after the blockage has been treated and the new risks lie elsewhere. Another frequent gap is copying groin-access precautions, such as long bed rest, for a patient whose stent went in through the wrist. Some plans mention antiplatelet drugs only in passing, though stopping them early is a leading preventable cause of stent clotting. Many skip discharge conditions. Rank by what can go wrong now, tailor checks to the access site, treat adherence as a priority, write measurable outcomes and confirm each discharge condition before he leaves. Then reread the ranking as if you were the night nurse.

Get an NU142 Unit 4 example written to your instructions

Heart failure, a stent, a clot in the leg or a new rhythm: name the condition behind the Unit 4 care plan in your section. Along with the case, attach the column template, the approved diagnosis list if there is one, and the rubric. What returns is ranked to that case's data. Free as a first custom sample; ready in 24-48h. 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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NU142 Unit 4 questions, answered

Where can I find a free NU142 Unit 4 sample paper?

The complete NU142 Unit 4 care plan after radial stenting is on this page, with four ranked priorities, rationales, outcomes, interventions, discharge readiness and evaluation, citing three sources. Tell us about your cardiac patient and we can rank the priorities with you.

Why does radial access change the care plan?

Access through the wrist causes less major bleeding than access through the groin, so long bed rest and groin hematoma checks give way to wrist and hand checks, including warmth, color and sensation.

Why is the radial site ranked first in NU142 Unit 4?

He takes two antiplatelet drugs and the puncture is fresh. A forearm hematoma can compress nerves and vessels, and closure of the radial artery could reduce blood flow to the hand.

Why is antiplatelet adherence a nursing priority?

Stopping aspirin or ticagrelor early is the strongest preventable cause of stent clotting. Teaching why both drugs matter, and for how long, protects the stent after discharge.

What conditions must be met before discharge after a stent?

A dry, soft site with a warm hand for several hours after band removal, first antiplatelet doses taken with a prescription he can fill, and knowledge of whom to call for swelling, numbness, bleeding or chest pain.