Schmitt-Thompson's adult leg swelling protocol, worked question by question for one composite caller, leads this NU432 Unit 4 triage scenario to a same-day disposition the closing clinic cannot meet. Searches like "nu 432 unit 4 assignment example", "nu432 unit 4 sample" and "nu432 unit 4 example" land here.
A Swollen Calf at 4:40 With the Practice Closing at 5:00: A Telephone Triage Record and Its Rationale
[Student Name]
Purdue University Global
NU432: Primary Care in the Ambulatory Setting
Unit 4 Assignment
[Instructor Name]
[Date]
Composite caller written as a model document. Protocol text is paraphrased, not reproduced.
Call Record
16:40: call received. Caller identity confirmed with name and date of birth.
Reason for call, in his words: "My left calf is swollen and sore since yesterday."
Difficulty breathing? No. Chest pain? No. Coughing blood? No. Fainting or near fainting? No. Fever? No.
Onset: yesterday morning, two days after a nine-hour drive.
Which leg: left only. Swelling: calf larger than the right, by his estimate. Redness: slight. Warmth: yes.
Recent surgery, cancer treatment, hormone use or prior clot: none.
Pertinent negatives recorded: no breathing symptoms, no chest pain, no bleeding.
Disposition: protocol for leg swelling, level reached: see a clinician within four hours.
Site: emergency department with ultrasound available on site, because the nearest urgent care has none.
Care advice given: do not massage the leg; go now; call 911 for chest pain or shortness of breath.
Teach-back: he repeated where he was going and the two reasons to call 911.
Routed: message to his primary care clinician for follow-up tomorrow.
Rationale: Why the Order Matters
Protocols rank questions from most to least serious, and the first positive answer sets the disposition (Briggs, 2020). Nothing was positive until the calf itself, which is why the level landed at four hours rather than at emergency medical services. One-sided calf swelling after prolonged travel raises concern for deep vein thrombosis, which is usually confirmed or excluded with ultrasound, often guided by a clinical probability score and a D-dimer test (Wells et al., 2003).
Rationale: Why the Site Changed
A four-hour window starting at 4:40 cannot be met in a practice closing at 5:00, and the nearest urgent care cannot image the leg. The site decision is recorded as a separate judgment, with its reason, so a reader can see that the disposition and the site were two decisions.
What a Nurse May Change
A nurse may upgrade a disposition on judgment, for example sending a caller to the emergency department sooner than the protocol requires. A downgrade needs a clinician's agreement, because it moves the caller away from care the protocol recommended.
About the Protocol Set
The composite practice uses a licensed set of Schmitt-Thompson protocols in its triage software; this record paraphrases the questions rather than reproducing the licensed text. The next morning the RN checked the hospital record: he had been seen within the window, and the follow-up visit was booked.
References
Briggs, J. K. (2020). Telephone triage protocols for nurses (6th ed.). Wolters Kluwer.
Wells, P. S., Anderson, D. R., Rodger, M., Forgie, M., Kearon, C., Dreyer, J., Kovacs, G., Mitchell, M., Lewandowski, B., & Kovacs, M. J. (2003). Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. New England Journal of Medicine, 349(13), 1227-1235. https://doi.org/10.1056/NEJMoa023153
How this NU432 Unit 4 example is structured
Sequence is the point, so the record keeps the order of the call. Emergent questions come first because the protocol ranks them that way, and the rationale explains the rule behind it: questions run from most to least serious, and the first positive answer sets the disposition. Here nothing is positive until the calf itself, which is why the level lands where it does. The rationale then deals with the clock. A four-hour window at 4:40 cannot be met in a practice closing at 5:00, so the note records the site decision as a separate judgment, with the reason written down. A short paragraph explains what a nurse may upgrade on judgment and why a downgrade needs a clinician's agreement. The closing section describes Schmitt-Thompson only as the licensed protocol set the composite practice uses, paraphrasing rather than reproducing its text.
Get an NU432 Unit 4 example written to your instructions
Triage prompts vary by symptom and by protocol set, so paste the scenario exactly as given, note whether your course uses Schmitt-Thompson or another system, and attach the rubric. A model call record, questions before disposition, returns in 24-48h, and the first one is free. The caller is invented, and the sample advises no one. 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.
NU432 Unit 4 questions, answered
Can the triage scenario quote the Schmitt-Thompson protocol?
Keep quotation to a minimum. The protocols are licensed content, so most papers cite the protocol title, the edition the practice uses and the disposition level, then paraphrase the questions. That shows the reasoning without reproducing proprietary text. If your instructor supplied protocol excerpts as course material, the prompt usually says how they may be used.
What if my judgment disagrees with the protocol's disposition?
Document both. Nurses commonly upgrade a disposition when something about the caller worries them, such as a vague answer or a caller who sounds confused, and the note should say what prompted it. Downgrading below the protocol level normally needs a clinician's agreement, recorded with the name and time. The sample upgrades nothing, but its rationale explains the rule.
Does the write-up need the caller's exact words?
For the reason for call and the teach-back, yes, or as close as the scenario allows. Graders read those two places for evidence that the nurse heard the problem as the caller described it and confirmed the plan landed. Everywhere else, concise clinical wording is fine. Every word of the call in the sample is invented.