| Course | NU144 Medical-Surgical Nursing II |
|---|---|
| Unit | Unit 3 |
| Paper type | Concept map with written analysis |
| Length | About 850 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU144 Unit 3
Fluids for the Pressure, Trouble for the Lungs: A Concept Map of a Composite 61-Year-Old Woman With Pneumonia-Related Sepsis, Acute Kidney Injury and Worsening Oxygenation, Drawing the Lines Where Treating One Organ Costs Another
[Student Name]
Purdue University Global
NU144: Medical-Surgical Nursing II
Unit 3 Concept Map
[Instructor Name]
[Date]
The patient is composite; the map is given as nodes and labeled links because the original is a diagram, and values are bracketed where illustrative.
The Patient
[Mrs. R.], composite, 61, admitted with right lower lobe pneumonia, became septic on day two: blood pressure [92/54], heart rate [112], respirations [28], saturation [90] percent on [4] L. Her creatinine has doubled since admission, now [1.9] mg/dL, and urine output is [20] mL an hour. Chest X-ray shows the pneumonia plus new haziness in both lungs. She has received [2.5] L of fluid since arrival, and her lung sounds now include crackles at both bases that were not present that morning.
Nodes
1. Pneumonia: infection in the right lower lobe.
2. Sepsis: widespread vasodilation and leaky capillaries.
3. Low blood pressure and reduced organ perfusion.
4. Acute kidney injury: low urine output, rising creatinine.
5. Leaky lung capillaries: fluid moving into the alveoli of both lungs.
6. Worsening oxygenation.
7. IV fluid resuscitation.
8. Vasopressors.
9. Diuretics.
10. Oxygen and, if needed, noninvasive or invasive ventilation.
11. Antibiotics.
Labeled Links
1 to 2: "triggers." 2 to 3: "dilates vessels and shifts fluid, causing." 3 to 4: "reduces kidney blood flow, causing." 2 to 5: "damages capillary walls in the lungs, causing." 5 to 6: "fills alveoli, impairing gas exchange and causing." 11 to 1: "treats the source." This is the only intervention that helps every node downstream. 7 to 3: "restores volume, raising." 7 to 4: "may improve kidney perfusion." 7 to 5: "adds fluid that leaks into lungs, worsening." This is the central trade-off. 8 to 3: "restores vessel tone, raising pressure without adding volume." 8 to 5: "avoids the extra fluid that would worsen." 9 to 5: "removes fluid, easing." 9 to 3 and 9 to 4: "can lower pressure and kidney perfusion if given too early." A second trade-off. 10 to 6: "supports oxygenation while the lungs recover."
Every liter that helps her kidneys and pressure also crosses into her lungs, so the map marks fluid as both treatment and harm.
How the Trade-Offs Shape the Plan
Because she has already received [2.5] L and her lungs are filling, the plan shifts from more fluid to vasopressors to support her pressure, which raises perfusion without adding volume. Fluid is given only if signs of fluid responsiveness are present, such as a rise in blood pressure with a passive leg raise. Diuretics are held until her pressure is stable, since removing fluid too early could worsen her kidneys. Antibiotics continue on time because treating the source helps every organ (Cecconi et al., 2018). Each decision is made at the bedside with the provider, because the balance can shift within hours.
Nursing Priorities Read From the Map
1. Oxygenation: continuous saturation, breathing rate and work of breathing, with escalation to noninvasive support if saturation falls below target.
2. Perfusion: blood pressure trend, mean arterial pressure goal and vasopressor titration.
3. Kidney function: hourly urine output, daily creatinine, avoiding nephrotoxic drugs.
4. Fluid balance: intake and output, daily weight on the same scale, lung sounds before any fluid (Potter et al., 2023).
5. Infection: antibiotics on time.
What Would Shift the Balance
The balance changes as she changes. If her saturation fell below [88] percent on high-flow oxygen, the lungs would become the overriding priority, and the team would consider noninvasive ventilation or intubation, accepting that positive pressure can lower blood pressure further and may require more vasopressor. If her kidneys stopped producing urine and her potassium rose, kidney replacement therapy could remove fluid without dropping her pressure as much as diuretics. If her blood pressure stabilized off vasopressors, cautious diuresis would begin, lowering lung fluid while the nurse watched urine output and creatinine for signs the kidneys were suffering. Writing these turning points into the map helps the nurse recognize when the plan's priorities should change.
Her Course Over Two Days
Norepinephrine was started at a low dose, and no further fluid boluses were given. Her mean arterial pressure held above [65]. On high-flow oxygen her saturation rose to [94] percent. By day two she was off vasopressors, her urine output had returned to [50] mL an hour, and a small diuretic dose was started, with her creatinine falling to [1.4]. The map's trade-offs were visible in her course: holding fluid protected her lungs, and the vasopressor protected her kidneys without adding volume.
How to Read the Map
Infection sits at the left, sepsis at the center, and the three failing systems branch to the right. Treatments sit below, with ordinary links in black and trade-off links in red. The map shows the nurse why a single order, such as another fluid bolus, needs to be weighed against every system it touches (Harding et al., 2023).
References
Cecconi, M., Evans, L., Levy, M., & Rhodes, A. (2018). Sepsis and septic shock. The Lancet, 392(10141), 75-87. https://doi.org/10.1016/S0140-6736(18)30696-2
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.
Reading the NU 144 Unit 3 instructions
Unit 3 usually asks for a concept map linking a patient's medical diagnoses, physiology, assessment findings and interventions, with a written explanation. Students are expected to show how problems cause or worsen one another, not just list them. Many prompts want the nursing priorities to come out of the map, and some ask how interventions affect more than one system. Instructors look for labeled arrows that state the relationship, a clear central concept and interventions connected to the problems they treat. Where the original is a diagram, the written part must still make the logic readable. A brief explanation of how priorities were chosen is commonly required. Current sources should support the physiology and the plan, cited in APA 7 at the end.
How the NU 144 Unit 3 example is put together
The sample opens with Mrs. R.'s data on day two, including her fluid total and new crackles. A numbered list of eleven nodes follows, from pneumonia to ventilation support. The labeled links section states each arrow in words, separating ordinary links from the trade-offs, and a highlighted line notes that every liter crosses into her lungs. The written analysis explains how those trade-offs shape the plan, then ranks five priorities with what the nurse monitors for each. A section on what would shift the balance lists three turning points. Her two-day course shows the trade-offs playing out, and a short guide explains how to read the original diagram. Three sources support the physiology and nursing care.
NU144 Unit 3 rubric: what earns full points
Concept map rubrics in NU 144 tend to give points for completeness of the map, accuracy of the relationships, clarity of labels, integration of nursing priorities and the quality of the written explanation. Completeness rewards including the infection, each failing system and each treatment. Accuracy points depend on links that state real cause and effect, such as capillary leak causing fluid in the alveoli. Label clarity is earned by putting a verb on every arrow. Points for priorities go to a ranked list that follows from the map rather than from a generic template. The written explanation is scored on reasoning and on sources in APA 7. Maps that show conflicts between treatments usually score at the top of each category.
NU144 Unit 3 help: mistakes that cost points
Concept maps often lose points when arrows carry no label, leaving the reader to guess the relationship. Another common error is drawing every intervention to a single problem, which hides how treatments affect several systems at once. Some maps list nursing diagnoses in boxes without showing what causes them. Others crowd so many nodes onto the page that the main line of reasoning disappears. Start with the infection, draw the chain to each failing organ, then add treatments and ask what else each one touches. Mark any link where helping one system hurts another. Write the explanation so it can be followed without the diagram. Keep the node list short enough to read in one pass.
Get an NU144 Unit 3 example written to your instructions
Whether the Unit 3 case involves a failing liver, a heart and kidney pulling apart or several systems after surgery, it travels best with the map template and grading rubric attached. Nodes, cause arrows and cost arrows then come from that data, and where the template forbids a second line style the costs move into labeled notes. First custom sample free, 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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NU144 Unit 3 questions, answered
Where can I find a free NU144 Unit 3 sample paper?
The complete NU144 Unit 3 concept map is here, with eleven nodes, labeled links, the trade-offs between fluid, vasopressors and diuretics, ranked priorities and three sources. We can help you build a map for your own patient.
What is a trade-off link on a concept map?
A link showing that a treatment helping one problem worsens another. In this map, fluid raises blood pressure and kidney perfusion but adds fluid to leaky lungs.
Why were vasopressors chosen over more fluid?
She had already received 2.5 liters and had new crackles. A vasopressor raises pressure by restoring vessel tone without adding volume that would leak into her lungs.
Why were diuretics held in NU144 Unit 3?
Removing fluid while her pressure was low could reduce blood flow to her kidneys further. Diuretics were started only once she was off vasopressors and stable.
How many nodes should a concept map have?
Enough to show the cause, each affected system and each treatment, often eight to fifteen. Too many hides the main reasoning, and too few leaves out the links being graded.