| Course | NU144 Medical-Surgical Nursing II |
|---|---|
| Unit | Unit 8 |
| Paper type | Seminar reflection |
| Length | About 810 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU144 Unit 8
An Opening Estimate, Not a Prescription: A Seminar Reflection From a Composite Student Who Had Treated the Parkland Formula as an Order Until a Case of a 34-Year-Old Man Burned Across Forty Percent of His Body Showed the Numbers Moving
[Student Name]
Purdue University Global
NU144: Medical-Surgical Nursing II
Unit 8 Seminar Reflection
[Instructor Name]
[Date]
The seminar case and classmates are composite; values are bracketed where illustrative, and burn resuscitation is directed by the burn team.
The Belief I Brought
I had memorized the Parkland formula: four milliliters of lactated Ringer's per kilogram of body weight per percent of total body surface area burned, the first half given over the eight hours that follow the injury and the rest across the next sixteen. I thought of the result as the order. If the formula said a number, the nurse's job was to make sure that number went in.
The Case
Our instructor presented [Mr. D.], composite, 34, burned in a garage fire across [40] percent of his body, with deep partial-thickness and full-thickness burns of his trunk and legs. He weighed [80] kg. The formula gave [4] times [80] times [40], or [12,800] mL in 24 hours, with [6,400] mL in the first eight hours, about [800] mL an hour.
The instructor then showed the hourly record. In the second hour his urine output was [70] mL, well above his target, roughly [40] mL an hour at his weight. The burn team reduced the rate. In the fifth hour his output fell to [25] mL and the rate was increased. By the end of the first day he had received about [10,900] mL, less than the formula's total, and his urine output had stayed close to target.
The formula gave a starting rate; the patient's urine gave the instructions after that.
Why I Held the Belief
Looking back, I held the formula as an order because it was the part of burn care I could calculate exactly. In a topic full of uncertainty, depth of burn, infection, grafting, a formula felt solid. Our pharmacology course had trained me to treat a calculated dose as the dose, and I carried that habit into a situation where the number was only a guess about an individual's needs. Seeing the hourly record, with the rate changing up and down, showed me how different fluid resuscitation is from giving a medication.
How the Discussion Unfolded
When the instructor asked what the nurse should do in hour two, with urine at [70] mL, I said keep the rate, because the formula hadn't changed. A classmate disagreed, saying more urine than needed meant more fluid than needed. The instructor asked us what happens to that extra fluid in a person whose capillaries are leaking, and the answer, that much of it ends up in tissues rather than the bloodstream, made the danger concrete. I realized I had been treating urine output as a box to check rather than as the signal guiding the rate.
What Changed in My Thinking
I learned that the formula is an estimate of what an average patient might need, used to set the starting rate, and that resuscitation is then guided by the patient's response, especially hourly urine output. Another student, who works in emergency care, added that giving too much is a real danger, not just a waste. Excess fluid in burns can cause severe swelling, raised pressure in the abdomen, breathing problems and compartment syndrome in the limbs. Reviews have described a trend of patients receiving far more fluid than the formula predicts, sometimes called fluid creep, linked to these complications (Saffle, 2007).
What I Will Watch For
If I care for a burned patient, I will treat the calculated rate as an opening estimate and focus on hourly urine output measured accurately through a catheter (Potter et al., 2023), reporting output well above or below target so the rate can be adjusted. I will also watch the burned limbs and chest for tightness, circulation and breathing, and the abdomen for distention, since these show when fluid is becoming harmful. I will make sure the clock starts at the time of the burn, not the time of arrival, because hours lost before arrival must be made up (Harding et al., 2023).
What Still Puzzles Me
I am not yet sure how the team decides when urine output alone is misleading, for example when alcohol or certain medicines affect it, or when other measures such as lactate are added. I also want to understand when albumin is used to reduce the total volume. And I want to know how nurses keep track of the time since the burn across handoffs, since the schedule depends on it and a change of shift in hour seven could easily blur where the first eight hours end.
References
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.
Saffle, J. R. (2007). The phenomenon of "fluid creep" in acute burn resuscitation. Journal of Burn Care & Research, 28(3), 382-395. https://doi.org/10.1097/BCR.0B013E318053D3A1
NU144 Unit 8 instructions, in plain terms
Unit 8 often asks for a reflection on a seminar, usually following a reflective model: what you thought before, what happened, what you learned and how it will change your practice. Students are expected to be specific about a belief or assumption and the moment it shifted. Most prompts want a link to evidence, so the new understanding is supported rather than only felt. Instructors look for honest self-examination, including why the earlier view was held, and for concrete actions the student will take. First-person voice is expected, and most entries fill two to three pages. Even in a personal piece, any clinical claim needs a source in APA 7, with a short reference list.
Inside the NU144 Unit 8 example
The reflection opens with the belief, stating the formula and how the student thought of its result. The case follows with the calculation and the hourly record, and a highlighted line says the urine gave the instructions after the first rate. A section explains why the belief was held, tracing it to calculating doses in pharmacology. The discussion is described next, including the student's wrong answer about hour two and the question that changed it. What changed is supported by the Saffle review on fluid creep. A section lists what the student will watch, including timing every hour from the injury rather than from arrival. Two open questions about urine output and albumin close the piece.
NU144 Unit 8 rubric: what earns full points
In NU 144, a reflection rubric typically gives credit for description of the experience, depth of self-examination, connection to evidence, application to practice and writing. Description points need enough detail about the case for a reader to follow the turning point. Self-examination points go to explaining why the earlier view was held, not just stating it was wrong. Evidence points reward a source that supports the new view. Application to practice is scored on specific actions, such as reporting urine output outside a target. Writing points cover first-person clarity, organization and APA format. Reflections that admit remaining uncertainty often score higher in the depth category than those that claim complete understanding.
Common NU144 Unit 8 mistakes, and how to avoid them
Seminar reflections often lose points by summarizing the seminar instead of examining the student's own thinking. Another common mistake is a turning point described in general terms, such as "I learned a lot about burns," with no specific belief or moment. Some students skip the evidence because the piece is personal. Others list future actions too broad to check. Name the belief you brought, describe the moment in the case that challenged it, explain why you held it, support the new understanding with a source and give actions you could be observed doing. Keep the tone honest rather than polished. A real question you still have is better than a forced conclusion.
Get an NU144 Unit 8 example written to your instructions
Burns, a crush injury, a head injury or several at once: whichever the Unit 8 seminar took, note the belief it changed for you, attach the seminar question with the rubric it carries, and mention whether the reflection stands in for attendance. A composite case of that injury then carries the reflection, first person throughout. 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 8 questions, answered
Where can I find a free NU144 Unit 8 sample paper?
A complete NU144 Unit 8 seminar reflection is here, tracing a student's view of the Parkland formula from fixed order to opening estimate through a composite burn case, with three sources. We can help you shape your own reflection.
What is the Parkland formula?
An estimate of fluid needs in the first day after a major burn: 4 mL of lactated Ringer's per kilogram per percent of body surface burned, half in the first eight hours from the injury.
Why is the formula only a starting point in NU144 Unit 8?
Patients differ, so the rate is adjusted to their response, mainly hourly urine output. Giving the exact calculated amount regardless of response can cause too much or too little fluid.
What is fluid creep?
A trend of burn patients receiving far more fluid than the formula predicts, linked to severe swelling, raised abdominal pressure, breathing problems and compartment syndrome.
Why does the clock start at the time of the burn?
The schedule assumes fluid begins at the injury. Hours lost before arrival leave the patient behind, so the first-half volume is still due within eight hours of the burn.