NU144CL Unit 3 Tracheostomy Patient Workup Example

Course	NU144CL Medical-Surgical Nursing II Clinical
Unit	Unit 3
Paper type	Patient workup
Length	About 900 words, 6 pages double-spaced
Format	APA 7 student paper
School	Purdue University Global
Program	BSN (prelicensure)
Updated	October 2026

Free sample paper for NU144CL Unit 3

Two Lines for Nineteen Days in Intensive Care: A Patient Workup for a Composite 63-Year-Old Man Newly Transferred to the Floor With a Tracheostomy, a Gastrostomy Tube and Weakness in All Four Limbs

[Student Name]

Purdue University Global

NU144CL: Medical-Surgical Nursing II Clinical

Unit 3 Patient Workup

[Instructor Name]

[Date]

The patient is composite and carries no identifiers; values are bracketed where illustrative, and the workup follows the order of a typical program form rather than any one school's template.

What this part is doingThe intensive care course is cut to two lines so the page is spent on what matters on the floor, which is what this workup is judged on.

Transfer Summary

Influenza leading to acute lung injury; [16] days on a ventilator; tracheostomy placed on day [10]; weaned to humidified oxygen by tracheostomy collar [three] days ago. Transferred to the floor on [day 19].

Relevant History

Type 2 diabetes, managed with an insulin infusion in intensive care and now with scheduled and correction insulin. Stroke [six] years ago with no lasting deficit, relevant because it raises his risk of swallowing problems. No known lung disease before this illness. Lives with his wife, worked as a bus mechanic.

Airway

Tracheostomy: cuffed tube, size [7.0], cuff [deflated] per the respiratory therapist's plan. Humidified oxygen at [28] percent by collar, saturation [94] percent. Secretions thick, pale yellow, moderate amount; suctioning needed about every [two] hours. Stoma clean, skin intact under the ties, ties allowing one finger beneath. Emergency equipment at the bedside, checked at the start of the shift: a spare tube of the same size and one size smaller, the obturator, a working suction setup with catheters, an oxygen source and a bag-valve device. The sign above the bed states the tube type and size. These items are part of the assessment, because if the tube comes out or blocks, there is no time to look for them (McGrath et al., 2012).

What this part is doingListing the checked emergency equipment as assessment data shows the student thinking about the airway's worst moment, not only its current state.

Nutrition

Tube feeding through the gastrostomy at [60] mL per hour, continuous, while he stays propped at [30] degrees or more. Tube site clean, no leakage. Weight [78] kg, down [9] kg since admission. Nothing by mouth pending a swallow evaluation.

Skin

Sacral stage 2 pressure injury measuring [2.2] by [1.4] cm, pink wound bed, no tunneling; foam dressing changed every [three] days and as needed. Turned every two hours with a pressure-redistributing mattress.

Mobility and Strength

Weakness in all four limbs, worse in the legs. He can lift his arms against gravity but not against resistance, and he cannot stand without two people. Weakness that develops during critical illness, from muscle and nerve damage, is common after long ventilation and sedation, and it can take weeks to months to recover (Vanhorebeek et al., 2020).

Labs, Transfer Value Beside Today

White count [14.2] / [9.8]. Hemoglobin [9.4] / [9.6]. Glucose [210] / [168]. Albumin [2.6] / [2.7]. Creatinine [0.9] / [0.8].

Medications With Reasons and Nursing Checks

Scheduled and correction insulin: glucose before each feeding check, hold rules followed if the feeding stops. Enoxaparin to prevent clots: platelet count and bleeding at the stoma and gastrostomy site. Acid-suppressing drug: given through the tube, flushed before and after. Inhaled bronchodilator by the respiratory therapist: heart rate and secretion change. Tube feeding: residual and tolerance per protocol, head of bed checked each visit.

Ranked Problems

1. Ineffective airway clearance related to thick secretions and a weak cough, shown by suctioning every two hours. Goal: clear breath sounds and saturation at or above [92] percent through the shift. Interventions: humidification kept running, suction only when needed, assisted coughing, position changes, the emergency equipment checked each shift.

2. Risk for aspiration related to continuous tube feeding, a prior stroke and weakness. Goal: no signs of aspiration, such as fever, new crackles or feeding-colored secretions. Interventions: head of bed at least [30] degrees at all times, including during turns where possible; feeding paused before lying flat; secretions watched for color.

A tube in his stomach does not protect his lungs; what goes into the stomach can still come back up, and the head of the bed is the first defense.

3. Impaired skin integrity, stage 2 sacral injury. Goal: wound smaller at the next weekly measurement with no new injury. Interventions: turning schedule, moisture control, dressing as ordered, nutrition with protein in the feeding.

4. Impaired physical mobility related to weakness acquired in intensive care. Goal: sits unsupported at the bedside, one helper only, by [day 22]. Interventions: physical and occupational therapy referral, daily sitting, range of motion, a call light he can press with his weak hand.

What this part is doingNaming weakness as its own problem, with its own goal, keeps it from being treated as a side note to the airway.

Lower-Ranked Issues, Kept Visible

Resolving delirium: oriented to person and place, not date; reassessed every shift, with day-night cues and his glasses. Ranked lower because it is improving and does not threaten his airway today. Sleep: broken by suctioning and turning; care is grouped to allow longer rest. Mood: he writes that he feels "trapped"; the team is told and a speaking valve trial is planned once his secretions lessen and the respiratory therapist confirms he can tolerate a deflated cuff. Being able to speak may help his mood more than anything else on the list.

What I Left Out and Why

The intensive care course runs to hundreds of pages: every ventilator setting, each sedation change, two line infections that resolved. None of it changes what I do today, so it stays in the chart. I kept the stroke because it affects his swallow and the weight loss because it affects his skin and strength (Harding et al., 2023).

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.

McGrath, B. A., Bates, L., Atkinson, D., & Moore, J. A. (2012). Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies. Anaesthesia, 67(9), 1025-1041. https://doi.org/10.1111/j.1365-2044.2012.07217.x

Vanhorebeek, I., Latronico, N., & Van den Berghe, G. (2020). ICU-acquired weakness. Intensive Care Medicine, 46(4), 637-653. https://doi.org/10.1007/s00134-020-05944-4

The Purdue Global NU144CL Unit 3 instructions

Unit 3 usually asks students to complete a full workup on the most complex patient of their assignment, following the program's form. Typical sections are a brief history, systems assessment, labs with trends, medications with reasons and nursing considerations, and ranked nursing problems with goals and interventions. Instructors judge what is left out as well as what is included, since a long intensive care stay can fill pages without changing today's care. They also look for safety-related assessment, such as emergency equipment for an artificial airway. Identifiers are never included. Problems should be ranked with reasons, and the workup is supported by a medical-surgical text or guideline, with a short APA 7 reference list attached.

Inside the NU144CL Unit 3 example

The workup opens with a two-line transfer summary, then gives only the history that changes floor care, including a prior stroke that matters for swallowing. The airway section describes the tube, secretions and stoma and lists each emergency item checked at the bedside, citing the tracheostomy emergency guidelines. Nutrition, skin and mobility follow, with weakness after critical illness explained from a review in intensive care medicine. Labs are paired with their transfer values, and each medication has a reason and a check. Four ranked problems carry goals and interventions, with a highlighted line on aspiration. A section keeps delirium, sleep and mood visible, and a closing note explains what was left out.

NU144CL Unit 3 rubric: what earns full points

Workup rubrics in NU 144CL usually assign points to relevant assessment data, accurate interpretation of labs and medications, ranked nursing problems, measurable goals, appropriate interventions and professional presentation. Data points depend on selecting what affects today's care. Interpretation points reward trends, such as a glucose falling from transfer, and medications linked to this patient's reasons. Problem ranking is graded on putting the airway first with a defensible order after it. Goal points need numbers and dates. Interventions must match each problem, including safety measures like head-of-bed elevation during feeding. Presentation covers the program form, absence of identifiers and an accurate APA 7 reference list.

NU144CL Unit 3 help: mistakes that cost points

Workups for patients transferred from intensive care often lose points by copying the whole critical care course into the history. Another frequent miss is listing the tracheostomy without the emergency equipment, which is the first thing to check. Some students rank skin above aspiration, or leave weakness out because it seems outside nursing's reach. Others list medications without saying why this patient takes them. Summarize the stay in two lines, describe the airway and the equipment that protects it, pair each lab with its earlier value, explain each drug for this patient and rank problems by what could harm him soonest. Keep lower-ranked issues on the page with a reason for their place.

Get an NU144CL Unit 3 example written to your instructions

Send the blank workup form and rubric, plus a few de-identified lines on the problems your assigned patient carries. What returns is that form completed for an invented patient whose course is comparable; the workup on your real patient, built from the record and your own assessment, is your work, not the model's. Free as a first custom sample, 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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NU144CL Unit 3 questions, answered

Where can I find a free NU144CL Unit 3 sample paper?

This page holds the full NU144CL Unit 3 patient workup for a composite man with a tracheostomy, gastrostomy feeding and weakness after intensive care, with ranked problems and three sources. Send your patient details if you need a workup built the same way.

What emergency equipment belongs at a tracheostomy bedside?

A spare tube of the same size and one smaller, the obturator, working suction with catheters, an oxygen source and a bag-valve device, checked at the start of each shift.

Why is aspiration ranked above the pressure injury?

Feeding can reflux into the lungs and cause pneumonia quickly, especially after a stroke and with weakness. A stage 2 sacral wound is serious but less immediately dangerous.

What is ICU-acquired weakness?

Muscle and nerve damage that develops during critical illness, often after long ventilation and sedation. Recovery can take weeks to months and needs therapy.

How long should the NU144CL Unit 3 history be?

Short. Include only what changes care on the floor, such as the reason for the tracheostomy or a prior stroke, and leave the full intensive care record in the chart.