Four tests, four reasons: an NU610 Unit 2 SOAP note for chronic loose stools in a composite adult, defending each order in one sentence and explaining two left out. Searches like "nu 610 unit 2 assignment example", "nu610 unit 2 sample" and "nu610 unit 2 example" land here.
Focused SOAP Note: Seven Weeks of Loose Stools Without Alarm Features, Four Tests and a Reason for Each
[Student Name]
Purdue University Global
NU610: NP III Clinical - Primary Care Focus
Unit 2 Focused SOAP Note
[Instructor Name]
[Date]
The patient is composite; dates, counts and results are bracketed, and treatment appears only as bracketed composites.
Subjective
Chief complaint: "My stomach has been off for almost two months." [Seven weeks] of [three to four] loose, nonbloody stools a day, with cramping relieved by defecation and some bloating. No nocturnal stools, no fever, no weight loss, no recent antibiotics, no new medications or supplements, no sweeteners such as sorbitol. No travel abroad. A camping trip [nine weeks] ago in [state], drinking from a stream after using a filter she was not sure worked. No sick contacts. Diet unchanged. No family history of celiac disease, inflammatory bowel disease or colorectal cancer. Last menstrual period [date]; no gynecologic symptoms. Mood fine, work stressful but no more than usual.
Objective
Temperature [36.8 °C], heart rate [74], blood pressure [118/76]. Weight [63.1 kg], unchanged from [63.4 kg] at her visit [last year]. No pallor. Abdomen soft, nondistended, slight left lower quadrant tenderness, no guarding, normal bowel sounds, no masses or organomegaly. No perianal findings on external inspection. No rash, no mouth ulcers, no joint swelling.
Assessment
Chronic diarrhea, [seven weeks], without alarm features: no blood, no nocturnal symptoms, no weight loss, no anemia on exam, no family history. The absence of alarm features makes a structural or malignant cause unlikely and supports a limited first round of testing.
Ranked differential:
1. Giardiasis: the stream exposure fits the timing, and Giardia commonly causes prolonged watery stools with bloating.
2. Celiac disease: common, often presents with diarrhea and bloating in young women, and easily missed.
3. Irritable bowel syndrome with diarrhea: cramping relieved by defecation fits, but it is a diagnosis to make after the first two are excluded, not before.
4. Early inflammatory bowel disease: less likely without blood, nocturnal stools or weight loss, but not excluded by history alone.
Plan
Giardia stool antigen: tests the leading candidate directly. A positive result leads to treatment, [a bracketed composite regimen], and household counseling; a negative one moves giardiasis down but does not end the search.
Tissue transglutaminase IgA with total IgA: screens for celiac disease while she is still eating gluten, which she should continue until results return. A positive result leads to referral for duodenal biopsy; a normal result with normal total IgA makes celiac disease unlikely (Rubio-Tapia et al., 2023).
Fecal calprotectin: separates inflammatory from functional causes. A raised value leads to gastroenterology referral for colonoscopy; a normal one makes inflammatory bowel disease unlikely and supports a functional diagnosis if the other tests are also negative.
Complete blood count: checks for anemia or a raised white count that the exam could miss. An abnormal result would add an alarm feature and bring referral forward.
Considered and not ordered: an ESR and a CRP. Guidance on laboratory testing in suspected functional diarrhea advises against using these markers to screen for inflammatory bowel disease, and recommends fecal calprotectin instead, along with Giardia and celiac testing (Smalley et al., 2019). Ova and parasite microscopy was also not ordered, since the antigen test is the better choice for Giardia and she has no travel history suggesting other parasites.
If all four tests are negative, the working diagnosis becomes irritable bowel syndrome with diarrhea, and management would follow a positive diagnostic approach rather than more testing (Lacy et al., 2021), with [bracketed composite first-line measures].
Follow-up: results call in [one week]. She will call sooner, or go to urgent care, for blood in the stool, fever, nighttime diarrhea, weight loss or symptoms of dehydration.
References
Lacy, B. E., Pimentel, M., Brenner, D. M., Chey, W. D., Keefer, L. A., Long, M. D., & Moshiree, B. (2021). ACG clinical guideline: Management of irritable bowel syndrome. American Journal of Gastroenterology, 116(1), 17-44. https://doi.org/10.14309/ajg.0000000000001036
Rubio-Tapia, A., Hill, I. D., Semrad, C., Kelly, C. P., Greer, K. B., Limketkai, B. N., & Lebwohl, B. (2023). American College of Gastroenterology guidelines update: Diagnosis and management of celiac disease. American Journal of Gastroenterology, 118(1), 59-76. https://doi.org/10.14309/ajg.0000000000002075
Smalley, W., Falck-Ytter, C., Carrasco-Labra, A., Wani, S., Lytvyn, L., & Falck-Ytter, Y. (2019). AGA clinical practice guidelines on the laboratory evaluation of functional diarrhea and diarrhea-predominant irritable bowel syndrome in adults (IBS-D). Gastroenterology, 157(3), 851-854. https://doi.org/10.1053/j.gastro.2019.07.004
How this NU610 Unit 2 example is structured
Subjective opens with the complaint in the patient's words and runs through the features that separate inflammatory, infectious and functional causes, closing on the exposure history. Objective holds measured data only, the weight trend included. Assessment gives one working frame, then ranks four candidates with the finding behind each. The plan is where this note earns its marks: every test sits on its own line, followed by one sentence stating which candidate it addresses and what a positive or negative result would do next. The 2019 AGA guideline on laboratory evaluation of functional diarrhea is cited for the calprotectin, Giardia and celiac choices, and for its advice against ESR or CRP as screens for inflammatory bowel disease. Treatment appears only as bracketed composites. A results call in one week closes the note, along with the alarm features that would bring it forward.
Get an NU610 Unit 2 example written to your instructions
Share the Unit 2 scenario, the SOAP template your NU610 instructor uses, and the rubric. A free first note is prepared to those materials within 24-48h, ranking the candidates, giving every ordered test one sentence of justification, and recording each test deliberately left out beside the evidence for leaving it out. 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.
NU610 Unit 2 questions, answered
How long should each test justification be?
One sentence is usually enough if it names the diagnosis the test addresses and the decision a result would change. Longer explanations belong in the assessment. The plan should read as a list a colleague could act on, with each order carrying its reason close enough that nobody has to search the note to find why it was requested.
Should tests I decided against appear in the note?
Often, yes, when a reader might expect them. A short line recording that a test was considered and not ordered, with the reason or source, shows the decision was deliberate. You do not need to list every possible study, only the ones a grader or a colleague would otherwise wonder about when reading your plan.
What if my section's template has no place for reasoning in the plan?
Add the reason on the same line as the order, after a colon, rather than creating a new section. Most templates tolerate a brief rationale beside each item. If yours forbids it, move the justifications into the assessment and number them so each maps to its test in the plan without anyone having to guess.