| Course | NU648 Specialized Pharmacology for the AGACNP |
|---|---|
| Unit | Unit 2 |
| Paper type | Dosing weight worksheet |
| Length | About 650 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU648 Unit 2
Three Weights, Five Drugs: A Dosing Weight Worksheet for a 138-Kilogram Woman Admitted With Diabetic Foot Osteomyelitis
[Student Name]
Purdue University Global
NU648: Specialized Pharmacology for the AGACNP
Unit 2 Dosing Weight Worksheet
[Instructor Name]
[Date]
The patient is composite; doses and laboratory values are bracketed, and each assignment names its source rather than prescribing for a real patient.
The Three Weights
Total body weight (TBW): [138] kg, measured on the bed scale at admission. Ideal body weight (IBW), female: 45.5 kg plus 2.3 kg for each inch over 60 inches. Height [170] cm is [66.9] inches, so IBW is 45.5 plus 2.3 times [6.9], about [61.4] kg. Adjusted body weight (AdjBW): IBW plus 0.4 times the difference between TBW and IBW. That is [61.4] plus 0.4 times [76.6], about [92.0] kg. Ratio of TBW to IBW: about [225] percent. Above roughly 120 percent, the choice of weight begins to change doses meaningfully.
Kidney Function Estimate
Serum creatinine [0.9] mg/dL. Cockcroft-Gault for a woman multiplies (140 less her age) by the chosen weight, divides by the product of 72 and serum creatinine, and applies a factor of 0.85. With TBW: about [159] mL/min. With IBW: about [71] mL/min. With AdjBW: about [106] mL/min. The same patient has a kidney function estimate that varies more than twofold depending on which weight goes into the equation. In overweight and obese adults, using adjusted body weight in the equation gave less biased estimates than total or ideal weight (Winter et al., 2012). This worksheet uses AdjBW, about [106] mL/min, for renal dose decisions, and flags it for recalculation if creatinine changes.
Five Drugs
1. Vancomycin loading dose. Weight: TBW. Source: the consensus guideline advises a loading dose of 20 to 35 mg/kg of actual body weight in serious infections, with a maximum of 3,000 mg (Rybak et al., 2020). Calculation: 20 mg/kg times [138] kg is [2,760] mg; the order is [2,750 mg], below the cap. Reasoning: vancomycin distributes into extra body mass, so an IBW-based load would underdose her.
2. Vancomycin maintenance. Weight: none directly; AUC-guided dosing using Bayesian software, with kidney function from AdjBW as an input. Source: the same guideline recommends AUC-guided dosing and cautions that obese patients often need maintenance doses well below what TBW would suggest, since clearance does not rise in proportion to weight (Rybak et al., 2020). Reasoning: a TBW-based maintenance dose risks accumulation and kidney injury.
3. Enoxaparin for venous thromboembolism prophylaxis. Weight: TBW. Source: evidence reviews suggest weight-adjusted prophylaxis in severe obesity, commonly about 0.5 mg/kg of actual weight, because the fixed 40 mg dose may produce low anti-factor Xa levels at her size (Nutescu et al., 2009). Calculation: [0.5] mg/kg times [138] kg, about [70] mg once daily, per the hospital protocol. Kidney check: AdjBW estimate above 30 mL/min, so no renal reduction. Anti-factor Xa monitoring: considered, per protocol.
4. Piperacillin-tazobactam. Weight: none. Source: standard adult dosing is fixed, [4.5 g] every [6 to 8] hours, often as extended infusion. Reasoning: fixed dosing with extended infusion maximizes time above the organism's minimum inhibitory concentration; kidney function by AdjBW supports the full dose.
5. Basal insulin glargine. Weight: TBW, with a conservative factor. Source: inpatient guidance bases starting insulin doses on body weight and advises lower starting doses for patients at risk of hypoglycemia (American Diabetes Association Professional Practice Committee, 2025). Calculation: [0.2] units/kg times [138] kg, about [28] units total daily insulin, with [half] as basal. Reasoning: insulin requirements rise with body mass and insulin resistance, so IBW would underdose; a lower factor offsets poor intake during infection.
One More Drug the Weight Does Not Change
Acetaminophen is dosed as a fixed adult dose, up to [3 g] daily in this patient, regardless of weight above 50 kg. It is listed here because a team member suggested weight-based dosing; this worksheet records why it does not apply.
References
American Diabetes Association Professional Practice Committee. (2025). 16. Diabetes care in the hospital: Standards of care in diabetes 2025. Diabetes Care, 48(Suppl. 1), S321-S334. https://doi.org/10.2337/dc25-S016
Nutescu, E. A., Spinler, S. A., Wittkowsky, A., & Dager, W. E. (2009). Low-molecular-weight heparins in renal impairment and obesity: Available evidence and clinical practice recommendations across medical and surgical settings. Annals of Pharmacotherapy, 43(6), 1064-1083. https://doi.org/10.1345/aph.1L194
Rybak, M. J., Le, J., Lodise, T. P., Levine, D. P., Bradley, J. S., Liu, C., Mueller, B. A., Pai, M. P., Wong-Beringer, A., Rotschafer, J. C., Rodvold, K. A., Maples, H. D., & Lomaestro, B. M. (2020). Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. American Journal of Health-System Pharmacy, 77(11), 835-864. https://doi.org/10.1093/ajhp/zxaa036
Winter, M. A., Guhr, K. N., & Berg, G. M. (2012). Impact of various body weights and serum creatinine concentrations on the bias and accuracy of the Cockcroft-Gault equation. Pharmacotherapy, 32(7), 604-612. https://doi.org/10.1002/j.1875-9114.2012.01098.x
What the NU648 Unit 2 assignment asks for
The Unit 2 assignment asks you to work through dosing weight for an acute care patient whose body size changes the answer. You calculate total, ideal and adjusted body weight with the formulas shown, state the ratio of actual to ideal weight, and then decide which weight each drug on the list should be dosed by. Every decision needs a reason drawn from the drug's distribution or from a published dosing reference. The worksheet format is shorter than a paper, but each line still needs its source. Where references disagree, the instructions usually ask you to name the disagreement and choose one position rather than ignore it.
Inside the NU648 Unit 2 example
The example keeps the calculation and the decisions in separate parts. The first part shows each formula with the patient's height and weight entered, so a reader can check the arithmetic step by step. A second part runs the Cockcroft-Gault equation with all three weights and shows the kidney estimate more than doubling from one weight to another. The drug section then takes five decisions in turn: a vancomycin loading dose by actual weight, vancomycin maintenance by AUC-guided dosing, enoxaparin prophylaxis adjusted for weight, piperacillin-tazobactam at a fixed dose, and basal insulin started cautiously. Acetaminophen is added as a drug whose dose the weight does not change, which shows the question was asked rather than assumed.
Reading the NU648 Unit 2 grading rubric
Points in the Unit 2 rubric go to calculation accuracy, the match between weight and drug, the rationale and the sources. Calculation is usually the easiest criterion to lose, because one wrong conversion from centimeters to inches carries through every later line. The weight-to-drug match earns full points when the choice follows the drug's properties, such as a water-soluble drug dosed by adjusted weight. Rationale is judged on whether it explains the pharmacology rather than repeating a rule. Sources count when each drug has one, and when a disagreement between references is acknowledged. Presentation matters less in a worksheet, but a layout that separates the calculation from the decisions is easier to grade.
NU648 Unit 2 help: mistakes that cost points
The most common error is choosing one weight for every drug on the list, which is the exact problem the assignment is built to catch. Another is using the male ideal body weight formula for a female patient, or entering height in the wrong unit. Some students give final doses as if prescribing, which moves the worksheet out of its role and invites points lost for unchecked numbers. Others cite a general drug handbook when the question needs a consensus statement or a study. Lastly, many worksheets never say why a weight was chosen; a reason in one clear sentence per drug is enough, but it has to be there.
Get an NU648 Unit 2 example written to your instructions
Send the Unit 2 worksheet template your NU648 section uses, with the patient's height, weight and medication list, plus any rubric. The sample returns in 24-48h, free as a first order; each weight is computed in full and every drug is matched to the weight its pharmacology or label supports. 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.
More NU648 papers and MSN samples
- NU648 Unit 1: Hypoglycemia Medication Review Post
- NU648 Unit 3: Adverse Drug Event Analysis
- NU648 Unit 4: Perioperative Medication Plan
- NU648 Unit 5: Seminar Reflection on Xa Reversal
- NU648 Unit 6: Multimodal Pain Plan on Buprenorphine
- NU648 Unit 7: QT Prolongation Risk Review
- NU648 Unit 8: Beers Criteria Prescribing Review
- NU648 Unit 9: Electrolyte Replacement Case
- NU648 Unit 10: Fidaxomicin vs Vancomycin Comparison
- NU610 Unit 2: Focused SOAP Note
- NU605 Unit 2: Competency Self-assessment
- NU603 Unit 2: Evaluation Plan
- NU590 Unit 2: Practicum Proposal
NU648 Unit 2 questions, answered
Is lean body weight ever the right choice?
For some drugs, yes. Lean body weight, estimated with equations such as Janmahasatian's, is used by some references for certain anesthetic and sedative agents. The sample includes it only when the prompt's drug list calls for it, and then cites the reference that recommends lean weight for that agent specifically.
What if references disagree on which weight to use?
They sometimes do, particularly for older drugs studied before obesity was common. The sample names both positions, picks one for a stated reason, and cites both sources. A reasoned choice between documented options earns more credit than pretending the references agree, and it shows the references were actually consulted.
Should the worksheet include the final doses?
Only as bracketed placeholders, which is how the sample presents them. The graded skill is matching weight to drug with a reason; the resulting number depends on current references, pharmacist verification and the prescriber. Showing where a dose would come from, without offering one for an actual patient, keeps the worksheet within coursework.
Where can I find a free NU648 Unit 2 sample paper?
The full NU648 Unit 2 dosing weight worksheet is on this page, with the three weights calculated and each drug assigned a weight and a source. A free custom sample for your own patient and drug list can be requested if your case differs.
Which weight is used for vancomycin in NU648 Unit 2?
The sample follows the pharmacy society consensus, which bases vancomycin loading doses on actual body weight and adjusts maintenance dosing by levels. Your course may use a different reference, so the worksheet should cite whichever source the instructions name.