| Course | NU650 AGACNP Introduction to Acute Care Management I |
|---|---|
| Unit | Unit 10 |
| Paper type | Discharge summary |
| Length | About 710 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU650 Unit 10
Discharge Summary: Diverticular Bleeding in a 74-Year-Old Man, With Aspirin and Naproxen Stopped and a Polyp Result Still Pending
[Student Name]
Purdue University Global
NU650: AGACNP Introduction to Acute Care Management I
Unit 10 Discharge Summary
[Instructor Name]
[Date]
The patient is composite; dates, doses and values are bracketed, and the receiving clinician is named by role.
Header
Admitted: [Day 0]. Discharged: [Day 4]. Attending: hospitalist service. Author: AGACNP student, reviewed by the attending. Principal diagnosis: acute lower gastrointestinal bleeding from sigmoid diverticulosis, stopped without intervention. Procedure: colonoscopy on [Day 2], showing extensive sigmoid diverticula with an adherent clot in one, no active bleeding, and a [12] mm sessile polyp in the ascending colon, removed. To: primary care clinician, appointment on [Day 11], within [seven] days of discharge.
Hospital Course
Mr. [N.] presented with [three] episodes of painless maroon stool over [six] hours and one episode of lightheadedness on standing. Hemoglobin was [8.4] g/dL on arrival, down from [13.2] at his last clinic visit, and fell to [6.8] at [12] hours. He received one unit of red cells under a restrictive threshold of [7] g/dL, as the ACG guideline advises for lower gastrointestinal bleeding in patients without active cardiovascular disease (Sengupta et al., 2023), and his hemoglobin has been stable at [9.0 to 9.3] for [48] hours without further bleeding. Bleeding stopped on its own; colonoscopy on [Day 2], after bowel preparation, found no active bleeding site to treat.
The likely contributors were aspirin [81 mg], which he took daily on his own for primary prevention, and naproxen [220 mg] two to three times daily for knee pain, bought over the counter. Both were stopped on admission and are not restarted. He has no history of heart attack, stroke or coronary stent, so aspirin had no secondary prevention indication. Stopping two over-the-counter drugs he chose himself is the single decision most likely to prevent the next bleed, and it only holds if the next clinician knows it was made.
Medications
Stopped:
1. Aspirin [81 mg] daily. Reason: taken for primary prevention only; the ACG guideline advises stopping aspirin used for primary prevention after a lower gastrointestinal bleed.
2. Naproxen, over the counter. Reason: nonsteroidal anti-inflammatory drugs raise the risk of recurrent diverticular bleeding; avoid all of them, including ibuprofen.
Started:
1. Ferrous sulfate [325 mg] by mouth every other day, for iron deficiency after blood loss; ferritin [22] ng/mL.
2. Acetaminophen for the knees, [650 mg] per dose when needed, no more than [2 g] in a day.
Changed: none. Continued unchanged: his statin (atorvastatin [20 mg]) and his blood pressure tablet (amlodipine [5 mg]), both once a day.
Pending Results
1. Pathology of the [12] mm ascending colon polyp, expected [Day 7 to 10].
Who acts: the gastroenterology office will receive the result and will call Mr. [N.] and send a letter to the primary care clinician with the surveillance colonoscopy interval. What the action is: if the polyp is an adenoma or sessile serrated lesion, a surveillance colonoscopy interval will be set by gastroenterology; if it shows high-grade dysplasia or cancer, gastroenterology will arrange review within [two] weeks. Safety check: the primary care clinician is asked to confirm at the [Day 11] visit that the result has been received and communicated. Test results that return after discharge are a known safety gap: many are potentially actionable and physicians are often unaware of them (Roy et al., 2005), and pending results are missing from most discharge summaries (Kripalani et al., 2007). That is why this result has a heading of its own.
Follow-Up
1. Primary care, [Day 11]: complete blood count; confirm the polyp result; review knee pain control without anti-inflammatory drugs.
2. Gastroenterology: by letter with the pathology result; clinic visit only if pathology requires it.
3. Repeat complete blood count and ferritin at [six to eight] weeks to judge the iron response.
Condition at Discharge and Instructions
Stable, walking independently, eating a regular diet. Hemoglobin [9.1] g/dL. He was taught to return at once for more than one episode of maroon or red stool, dizziness or fainting, and to avoid all over-the-counter anti-inflammatory pain relievers. He repeated these instructions back correctly, and his daughter was present for the teaching.
References
Kripalani, S., LeFevre, F., Phillips, C. O., Williams, M. V., Basaviah, P., & Baker, D. W. (2007). Deficits in communication and information transfer between hospital-based and primary care physicians: Implications for patient safety and continuity of care. JAMA, 297(8), 831-841. https://doi.org/10.1001/jama.297.8.831
Roy, C. L., Poon, E. G., Karson, A. S., Ladak-Merchant, Z., Johnson, R. E., Maviglia, S. M., & Gandhi, T. K. (2005). Patient safety concerns arising from test results that return after hospital discharge. Annals of Internal Medicine, 143(2), 121-128. https://doi.org/10.7326/0003-4819-143-2-200507190-00011
Sengupta, N., Feuerstein, J. D., Jairath, V., Shergill, A. K., Strate, L. L., Wong, R. J., & Wan, D. (2023). Management of patients with acute lower gastrointestinal bleeding: An updated ACG guideline. American Journal of Gastroenterology, 118(2), 208-231. https://doi.org/10.14309/ajg.0000000000002130
Reading the NU 650 Unit 10 instructions
The Unit 10 assignment asks you to write a discharge summary for a hospitalized adult, addressed to the clinician who will take over care. You record dates, diagnoses and procedures, summarize the hospital course by problem, reconcile medications with reasons for every change, list results still pending with who will act on them, give follow-up appointments and document the patient's condition and instructions. The summary should be as short as the stay allows and organized for the reader, not the writer. Most sections expect about two to three pages with sources supporting key decisions, such as stopping a medication. Write it for a reader who has never met the patient and has ten minutes before the visit.
How this NU650 Unit 10 example is built
The example puts the diagnosis, procedure and receiving clinician in the header, since those are read first. The hospital course is written by problem rather than by day, so the decision to stop aspirin and naproxen is not buried. It notes the transfusion threshold used and cites the ACG guideline. Medications are grouped four ways, each change with a one-line reason. The pending results section gives the polyp pathology an owner, an expected date, the actions for each possible result and a check for the primary care visit, with two studies on why pending results are a safety gap. Follow-up, condition at discharge and teach-back instructions complete it.
Reading the NU650 Unit 10 grading rubric
The Unit 10 rubric gives points for completeness of required elements, accuracy of the hospital course, medication reconciliation, handling of pending results, follow-up planning and clarity for the receiving clinician. Medication reconciliation is weighted heavily; every stopped drug must be named with a reason, or it may be restarted by habit. Pending results earn full credit only when an owner and an action are named. The hospital course is judged on relevance, so a day-by-day narrative scores lower than a problem-based summary. Follow-up counts when appointments have dates and purposes. Patient teaching, confirmed by teach-back, is part of a complete summary. Clear headings that a busy reader can scan also count toward the clarity criterion.
NU650 Unit 10 help: mistakes that cost points
The most common mistake is listing only current medications, so the next clinician never learns that aspirin and naproxen were stopped. Another is mentioning a pending test without saying who will act on it. Students often write the hospital course as a daily diary. Some omit the reason for stopping a drug, which invites someone to restart it. Follow-up appointments are sometimes listed without what the visit should check. Teaching is recorded as done without evidence the patient understood. And iron deficiency after a bleed is frequently missed in the plan, though it affects how he recovers. Read it once as the receiving clinician would and ask whether anything still needs a phone call.
Get an NU650 Unit 10 example written to your instructions
Everything the NU650 Unit 10 prompt provides about the stay, plus the rubric and any template the section requires, is enough to begin. A first sample is free and returns in 24-48h: one page for an invented patient, written for the clinician taking over, with medication changes split three ways and pending results assigned by name. 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.
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NU650 Unit 10 questions, answered
Why does the summary list medications that were stopped?
Because the patient's pharmacy record, home supply and primary care list may all still show them. A stopped anti-inflammatory that is not named as stopped is easy to restart by habit. Listing started, stopped and changed drugs separately, each with a reason, lets the next clinician reconcile the list quickly and explain the change to the patient.
Where can I find a free NU650 Unit 10 sample paper?
The complete NU650 Unit 10 discharge summary is on this page, with the hospital course by problem, medication changes with reasons, the pending polyp result and follow-up. For a different discharge diagnosis, a free sample written from your case can be requested.
How long is the NU650 Unit 10 discharge summary?
The sample runs about 800 words, roughly three pages, because it carries a pending result and several medication changes. A shorter summary is fine for a simpler stay, as long as it keeps every required element.
Who follows up the pending result in the NU650 Unit 10 sample?
The gastroenterology office receives the polyp pathology, calls the patient and writes to the primary care clinician with the surveillance interval. The primary care clinician confirms at the first visit that the result arrived, so no result depends on one person remembering it.
Why list stopped medications in the NU650 Unit 10 summary?
Because pharmacy records, home supplies and clinic lists may still show them. The sample names aspirin and naproxen as stopped with a reason for each, so neither is restarted by habit at the next visit.