Recorded in the patient's own words, a composite 88-year-old's goals, fears, tradeoffs and resulting orders make up NU584's Unit 7 summary, with a daughter's differing view kept separate. Searches like "nu 584 unit 7 assignment example", "nu584 unit 7 sample" and "nu584 unit 7 example" land here.
"My Own Kitchen, My Own Tea": A Goals-of-Care Summary for an 88-Year-Old With Advanced Parkinson Disease and a Swallow That Is Failing
[Student Name]
Purdue University Global
NU584: AGNP II - Primary Care of the Frail Elderly
Unit 7 Goals-of-Care Summary
[Instructor Name]
[Date]
The patient and family are composites; the date and orders are bracketed.
Header
Date: [date]. Participants: Mrs. [S.], 88; her daughter [name]; the nurse practitioner; the student. Capacity: she understood her condition, the options and their consequences, reasoned about them and expressed a consistent choice; she has capacity for this decision. Health care agent: her daughter, named in her advance directive.
Understanding, in Her Words
"The Parkinson's is getting into my throat. I cough when I drink, and I had pneumonia twice this winter." Paraphrase: she understands that her swallowing problems come from the Parkinson disease and caused her pneumonias.
Information Preferences
"Tell me straight. Don't dress it up."
Prognosis, Shared
Shared as a range with uncertainty: her swallowing is likely to worsen over months, and further pneumonias are likely; she may have months to a year or two, and it is hard to be more exact. Swallowing problems in advanced Parkinson disease commonly lead to aspiration pneumonia, a leading cause of death in the disease (Suttrup & Warnecke, 2016).
Goals, in Her Words
"My own kitchen, my own tea, for as long as I can manage it."
Fears
"Being stuck in a hospital bed with a tube in me. Not being able to taste anything."
Sources of Strength
Her church, her daughter's visits, her sewing, which she still does slowly.
Critical Abilities
"If I can't eat and drink, I don't want to go on with machines. I want to taste my food."
Tradeoffs
She would accept a hospital stay for pneumonia if it could return her home, and she would keep eating and drinking by mouth, knowing it carries a risk of more pneumonia, rather than have a feeding tube. She would decline intubation and CPR.
Her Daughter's View
Her daughter asked whether a feeding tube would keep her mother safe from pneumonia. She said, "I'm not ready to lose her." The nurse practitioner acknowledged her fear and her love, explained that a feeding tube does not prevent aspiration of saliva and would not return her mother to her kitchen, and returned to her mother's stated priorities. Her daughter said she would respect her mother's wishes, though it was hard.
Recommendations
Flowing from her goals: continue eating and drinking by mouth, with a speech-language pathology evaluation for strategies and textures that make swallowing safer and more comfortable, accepting the risk; treat pneumonia with antibiotics, at home when possible and in hospital if needed; no feeding tube; no intubation or CPR; a palliative care referral for symptom support at home. The framework of the Serious Illness Conversation Guide shaped the conversation's order (Bernacki & Block, 2014), and advance care planning is treated as an ongoing process, revisited as her illness changes (Sudore et al., 2017).
Actions
1. POLST completed: DNR; selective treatment, including hospital care for pneumonia; no artificial nutrition by tube. Copy to her home, her daughter and the chart.
2. Speech-language pathology referral: comfort-focused swallowing plan. Date: [date].
3. Palliative care referral. Date: [date].
4. Goals documented in the chart's advance care planning section, where any clinician will see them.
5. Revisit at the next visit, or sooner after any hospital stay.
6. Home health referral for a nurse visit after the speech-language evaluation, to check that the swallowing plan is workable in her kitchen and that her daughter knows the signs of pneumonia to report early.
References
Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: A review and synthesis of best practices. JAMA Internal Medicine, 174(12), 1994-2003. https://doi.org/10.1001/jamainternmed.2014.5271
Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., Matlock, D. D., Rietjens, J. A. C., Korfage, I. J., Ritchie, C. S., Kutner, J. S., Teno, J. M., Thomas, J., McMahan, R. D., & Heyland, D. K. (2017). Defining advance care planning for adults: A consensus definition from a multidisciplinary Delphi panel. Journal of Pain and Symptom Management, 53(5), 821-832. https://doi.org/10.1016/j.jpainsymman.2016.12.331
Suttrup, I., & Warnecke, T. (2016). Dysphagia in Parkinson's disease. Dysphagia, 31(1), 24-32. https://doi.org/10.1007/s00455-015-9671-9
How this NU584 Unit 7 example is structured
The note is ordered so the patient speaks before anyone interprets her. Capacity is documented first, briefly, because everything after depends on her being the decision-maker. The conversation domains follow in the guide's sequence, and each paragraph separates what she said from what the clinician inferred. Critical abilities and tradeoffs carry the most weight: she would accept a hospital stay for pneumonia if it could return her home, she would keep eating and drinking by mouth knowing the risk, and she would decline a feeding tube, intubation and CPR. The daughter's wish for a feeding tube is recorded without being blended into her mother's goals, and the note describes how the clinician acknowledged it and returned to the patient's stated priorities. Recommendations appear only after the goals, framed as flowing from them. The action list turns the conversation into orders and referrals that the next clinician will actually see.
Get an NU584 Unit 7 example written to your instructions
Send the Unit 7 scenario as your section posted it, including who is present and anything the patient says, with the rubric and the conversation framework your course teaches. The sample summary puts the patient's words first, keeps family views separate, and converts the goals into orders. It is free the first time, ready 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.
NU584 Unit 7 questions, answered
Should the summary quote the patient directly?
Where her words carry the decision, yes. Direct quotation of goals, fears and limits lets any later reader see exactly what was said, and it guards against a clinician's interpretation drifting into the record. Paraphrase the rest and label it as paraphrase. Graders often reward that distinction because it shows the note was written for the next clinician.
What if the family disagrees with the patient?
Record both views accurately and separately, then document how the disagreement was addressed. When the patient has capacity, her decisions govern, and the note should say so plainly. Acknowledging the family's fear or grief belongs in the note as well. Blending the two views into one, or omitting the family's, leaves the next clinician unprepared.
Is a POLST the same as an advance directive?
No. An advance directive, such as a living will or health care power of attorney, is completed by the patient and states wishes or names an agent. A POLST, by contrast, is a set of portable medical orders a clinician signs, meant for people with serious illness, and it moves with the patient between settings. States use different names and forms, so the sample brackets the state.