| Course | NU142CL Medical-Surgical Nursing I Clinical |
|---|---|
| Unit | Unit 5 |
| Paper type | Handoff report |
| Length | About 590 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU142CL Unit 5
The Day After a Below-Knee Amputation: An I-PASS Handoff for a Composite 77-Year-Old Man, Written So an Unfamiliar Nurse Could Carry On His Care From the Page Alone
[Student Name]
Purdue University Global
NU142CL: Medical-Surgical Nursing I Clinical
Unit 5 Handoff Report
[Instructor Name]
[Date]
The patient is composite; values and orders are bracketed where illustrative, and the facility's handoff tool governs format.
Illness Severity
Watcher. Stable vital signs, but new phantom limb pain is poorly controlled and his glucose has run high. Not unstable, but needs closer attention than a routine postoperative patient.
Patient Summary
[Mr. Z.], composite, 77, room [8] on the working copy. Right below-knee amputation yesterday for peripheral artery disease with a nonhealing heel wound and osteomyelitis. History: type 2 diabetes on insulin, high blood pressure, former smoker, chronic kidney disease stage 3 with creatinine [1.7]. Lives with his wife in a one-story house. Residual limb has a soft dressing with an elastic wrap and a closed-suction drain. Pain controlled with a nerve catheter yesterday, removed this morning; now on oral oxycodone and acetaminophen. Gabapentin started this morning for nerve pain. Aspirin and statin continued. Insulin: basal glargine plus correction.
Action List
1. Drain: empty and record output at [1600]; it was [60] mL serosanguineous since midnight.
2. Residual limb: check dressing and wrap for bleeding, tightness and wrinkles every four hours, rewrapping as taught if it loosens (Potter et al., 2023); keep the knee straight when lying, no pillow under the knee, to prevent a knee contracture.
3. Pain: reassess one hour after each oxycodone dose; he reports burning pain in the missing foot rated [7]; gabapentin just started and will take days to help.
4. Glucose: before meals and at bedtime; correction insulin per scale; morning glucose [248].
5. Physical therapy at [1400] for transfer training with a walker.
6. Kidney function: creatinine due tomorrow morning; watch urine output.
Situation Awareness and Contingency Planning
If the dressing shows bright red bleeding that soaks through, apply pressure with the wrap and call the surgeon. If his pain stays above [6] an hour after oxycodone, call for review; the team has suggested adding a scheduled dose. If he becomes confused or sleepy after gabapentin with oxycodone, hold the next opioid dose and call, since both cause sedation and his kidneys clear gabapentin slowly (Burchum & Rosenthal, 2022). If glucose rises above [300] twice, call the provider. Fall risk is high: he has tried to stand on the missing leg at night because it feels present.
He tried to stand on a leg he no longer has because it still felt real, so the fall plan has to account for phantom sensation, not only weakness.
Synthesis by Receiver
The receiving nurse repeats back: watcher status, drain output due at [1600], knee kept straight, gabapentin with opioid sedation risk, glucose thresholds, fall risk from phantom sensation. Questions asked: whether the wife will be present for teaching tomorrow, and whether a prosthetist visit has been requested. The giving nurse confirms the wife plans to come at [1000], and that the prosthetist referral was placed this morning, and adds both to the action list so the next shift can follow up.
Why I-PASS
The structure puts illness severity first so the receiving nurse knows how closely to watch, and ends with the receiver's own summary so misunderstandings are caught before the giver leaves. Its contingency plans name the action for each likely problem, which is what an unfamiliar nurse needs most (Harding et al., 2023).
References
Burchum, J. R., & Rosenthal, L. D. (2022). Lehne's pharmacology for nursing care (11th ed.). Elsevier.
Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C. (2023). Lewis's medical-surgical nursing: Assessment and management of clinical problems (12th ed.). Elsevier.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2023). Fundamentals of nursing (11th ed.). Elsevier.
NU142CL Unit 5 instructions, in plain terms
Unit 5 usually brings written handoff practice to its peak, testing whether the page alone would let an unfamiliar nurse continue the patient's care. Prompts commonly want a recognized structure, such as I-PASS or SBAR, with severity, a concise summary, tasks for the next shift, risks with planned responses and confirmation by the receiver. Instructors look for action items with times, contingencies written as if-then statements with thresholds, and attention to risks specific to this patient, such as contracture prevention after amputation or sedation from combined drugs. The receiver's read-back and questions should be recorded, since catching misunderstandings is part of what a structured handoff is for. Keep the summary brief. Patients are identified only by code.
How the NU 142CL Unit 5 example is put together
The report opens with illness severity and its reason. The patient summary covers the procedure, history, home situation, the dressing and drain, the pain plan with a new nerve pain drug and diabetes management. Six numbered actions follow, from drain output at 1600 to the morning creatinine. Contingency plans set thresholds for bleeding, pain, sedation, glucose and falls, with the highlighted line on phantom sensation and a margin note on thresholds. The receiver's read-back and two questions are recorded, with a second margin note, and a closing section explains why I-PASS places severity first and ends with the receiver's summary. Each contingency is a single if-then line.
NU142CL Unit 5 rubric: what earns full points
Written handoffs in NU 142CL are judged on structure, completeness of the action list, quality of contingencies and closed-loop confirmation. A recognized format, used in its proper order, is the starting point. The action list is credited for timed, specific tasks the next nurse must do. Contingencies carry substantial weight: each likely problem should have a threshold and an action. Closed-loop confirmation rewards a recorded read-back and the questions the receiver asked, with answers. Risks particular to the patient, such as contracture or sedation from combined drugs, separate a strong handoff from a generic one, with references in APA 7 behind the drug and wound points. A handoff that a float nurse could pick up mid-shift and act on is the target. Graders often test that by reading only the action list.
NU142CL Unit 5 help: mistakes that cost points
Handoffs often describe the patient's history at length and leave the next nurse to work out what needs doing and when. Another frequent gap is vague contingencies such as "monitor pain" with no threshold or action. Some reports overlook risks unique to the procedure, like keeping the knee straight after a below-knee amputation. Many leave out the receiver's confirmation. State severity first with its reason, keep the summary to what explains the plan, time every action, write each contingency as an if-then with a number, name procedure-specific risks and record the read-back and any questions answered before the giving nurse leaves. Write it for a nurse who has never met him.
Get an NU142CL Unit 5 example written to your instructions
Tell us which format your clinical group uses for Unit 5, I-PASS, SBAR or a unit form, and attach it with the rubric and a general outline of the kind of patient you handed over. The model returns built on a composite patient, receiver lines blank. A first custom sample is free; 24-48h is usual. 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.
More NU142CL papers and BSN samples
- NU142CL Unit 1: Discussion Board Post
- NU142CL Unit 2: Patient Workup
- NU142CL Unit 3: Organization Sheet
- NU142CL Unit 4: Clinical Journal
- NU142CL Unit 6: Patient Workup
- NU142CL Unit 7: Procedure Note
- NU142CL Unit 8: Case Study Analysis
- NU142CL Unit 9: Post-conference Post
- NU142CL Unit 10: Final Case Study
- NU142 Unit 5: Case Study Analysis
- NU141CL Unit 5: Case Study Analysis
- NU141 Unit 5: Case Study Analysis
- NU140CL Unit 5: Care Plan
NU142CL Unit 5 questions, answered
Where can I find a free NU142CL Unit 5 sample paper?
This page holds the full NU142CL Unit 5 I-PASS handoff after a below-knee amputation, with severity, summary, actions, contingencies and the receiver's read-back, citing three sources. Send your patient's details and we can draft a handoff in the same format.
What does I-PASS stand for?
Illness severity, patient summary, action list, situation awareness with contingency planning, and synthesis by the receiver, a structure that puts severity first and ends with the receiving nurse's own summary.
Why keep the knee straight after a below-knee amputation?
Lying with a pillow under the knee can lead to a knee contracture that makes fitting and walking with a prosthesis much harder, so the knee is kept straight when lying down.
Why is gabapentin with oxycodone a concern in NU142CL Unit 5?
Both cause sedation, and his reduced kidney function slows gabapentin clearance. The handoff tells the next nurse to hold the next opioid dose and call if he becomes confused or sleepy.
Why is phantom sensation a fall risk?
The missing leg can still feel present, so a patient may try to stand on it, especially at night. The fall plan accounts for this alongside weakness and new medicines.