Obstruction nausea, colicky pain and the secretions of the final days, each with a measure, drugs, comfort measures and a reassessment time, make up one NU435 Unit 4 symptom plan. Searches like "nu 435 unit 4 assignment example", "nu435 unit 4 sample" and "nu435 unit 4 example" land here.
Nausea From a Blocked Bowel: A Symptom Management Plan for a Woman Who Declined Surgery and Still Wants to Taste Food
[Student Name]
Purdue University Global
NU435: Hospice and Palliative Nursing Care
Unit 4 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Medications and doses are bracketed and ordered by the hospice physician.
Her Goals, in Her Words
"Fewer times throwing up. Some tea and broth every day. No tube in my nose."
Priorities From Her Symptom Form
On the Edmonton Symptom Assessment System at admission (Bruera et al., 1991), she ranked vomiting first, cramping second and fatigue third. Fatigue is acknowledged but not planned for here; she said she expects to be tired and wants her energy spent on visits from her grandchildren.
Section 1: Nausea and Vomiting
Measure: vomiting episodes counted each 24 hours; nausea rated 0 to 10. Comfort goal: no more than one episode a day; nausea at or below 4. Mechanism: a blocked bowel causes nausea through distension and pooled gut secretions, so drugs that push contents forward can make cramping worse and are avoided (Ferguson et al., 2015). Medications: [haloperidol] subcutaneously, to calm the vomiting center; [octreotide] subcutaneously, to reduce gut secretions. Without a prescription: small sips of tea and broth as she wishes; mouth care after each episode; a basin within reach. Reassessment: vomiting episodes counted over each 24 hours after octreotide begins.
Section 2: Colicky Pain
Measure: pain 0 to 10 and number of cramping episodes. Comfort goal: pain at or below 4. Medications: [glycopyrrolate] subcutaneously for cramping; her opioid moved to the subcutaneous route, since tablets are no longer reliably absorbed. Without a prescription: a warm pack to the abdomen; position of comfort. Reassessment: one hour after each dose change, then each visit. Mechanism comes first in each section because the drug choice follows from it.
Section 3: Secretions in the Last Days (Planned Ahead)
Dated as a plan for later. As she weakens, secretions may collect in her throat and make a rattling sound. Repositioning and gentle mouth care come first. Anticholinergic drugs are often used, but a Cochrane review found no evidence that any drug is better than placebo (Wee & Hillier, 2008), so the plan prepares her husband for the sound before it starts and explains that it usually does not distress her.
Family Teaching
Her husband asked three questions: Can she still eat? Yes, sips and tastes she enjoys, even if they come back up. Is the rattle choking? No; it is air moving over secretions she cannot clear. Who do I call at night? The hospice line, [number], which is answered at all hours. The answers were written on a card by the phone, in the order he asked them.
References
Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6-9.
Ferguson, H. J. M., Ferguson, C. I., Speakman, J., & Ismail, T. (2015). Management of intestinal obstruction in advanced malignancy. Annals of Medicine and Surgery, 4(3), 264-270. https://doi.org/10.1016/j.amsu.2015.07.018
Wee, B., & Hillier, R. (2008). Interventions for noisy breathing in patients near to death. Cochrane Database of Systematic Reviews, (1), CD005177. https://doi.org/10.1002/14651858.CD005177.pub2
How this NU435 Unit 4 example is structured
Symptoms are ordered by her own ranking, recorded on an Edmonton Symptom Assessment System form at admission: vomiting first, cramping second, fatigue acknowledged but not planned for here. Mechanism leads each section, because the drug choice follows from it. A blocked bowel produces nausea through distension and pooled gut secretions, which is why the plan reduces secretions and calms the vomiting center rather than trying to push contents through. Every intervention carries a reassessment time matched to its route and onset, such as vomiting episodes counted over each 24 hours after octreotide begins. The secretions section is written ahead of need, dated as a plan for later, and includes the modest evidence for anticholinergic drugs, which a Cochrane review found no evidence to favor over placebo. Family teaching sits last and repeats nothing clinical; it answers the questions her husband asked.
Get an NU435 Unit 4 example written to your instructions
Symptom plans are built on the patient the case gives, and swapping in a different symptom changes the whole mechanism. That is why the desk works from your scenario, your section's template if one exists, and your rubric. A first plan is free and typically lands in 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.
NU435 Unit 4 questions, answered
Does every symptom in the case need its own plan section?
Not always. Many prompts ask for the two or three symptoms that matter most to the patient, and a plan that ranks them by the patient's own distress and explains the omissions reads as judgment rather than as a gap. Check whether your instructions name specific symptoms, because then each one needs a full section with its measure, interventions and reassessment.
Should the plan include medications if nurses do not prescribe them?
Yes, as anticipated orders or recommendations, since hospice nurses work from standing comfort orders and advise prescribers daily. Name the drug, route and interval, bracket every amount, and cite the reference supporting the choice. The sample frames each medication as part of an interdisciplinary plan, which keeps it inside nursing scope and matches how most rubrics phrase that criterion.
How much evidence is enough for nonpharmacologic measures?
One source per measure is a sensible target, since those rows are often where plans go uncited. Mouth care, positioning and small sips for pleasure all have palliative nursing literature behind them. Where evidence is thin, say so, as the sample does for secretion management, because an honest limitation reads better to markers than an overstated claim.