NU650 Unit 6 Pneumonia Admission Orders Rationale Example

Course	NU650 AGACNP Introduction to Acute Care Management I
Unit	Unit 6
Paper type	Admission orders rationale
Length	About 870 words, 6 pages double-spaced
Format	APA 7 student paper
School	Purdue University Global
Program	MSN
Updated	September 2026

Free sample paper for NU650 Unit 6

Twelve Orders Written and Seven Left Out: An Admission Orders Rationale for a 64-Year-Old Man Admitted With Right Lower Lobe Pneumonia

[Student Name]

Purdue University Global

NU650: AGACNP Introduction to Acute Care Management I

Unit 6 Admission Orders Rationale

[Instructor Name]

[Date]

The patient is composite; doses, scores and values are bracketed, and the orders follow the admitting hospital's formulary.

What this part is doingA short case line sets the facts every order below depends on: severity, risk factors for resistant organisms and whether he can drink.

The Patient

Mr. [G.] is a [64]-year-old man with hypertension and type 2 diabetes who presents with [four] days of cough, fever and right-sided pleuritic pain. On his chest film, the right lower lobe is consolidated. Respiratory rate [22], pulse [98], blood pressure [134/82], temperature [38.6] degrees Celsius, saturation [93] percent without oxygen. His blood urea nitrogen is [24] mg/dL and he is alert, so his CURB-65 score is [1]. He has not been hospitalized or received intravenous antibiotics in the past [90] days and has no known MRSA or Pseudomonas. He is drinking and eating. He needs admission because his oxygen saturation is borderline, he lives alone and his glucose is [312] mg/dL.

Part One: Orders and Rationale

Admit. Medical floor, inpatient, under the hospitalist service. Rationale: he needs oxygen monitoring and intravenous antibiotics for more than [two] days, and he does not meet criteria for severe pneumonia that would call for a higher level of care.

Diagnosis. Community-acquired pneumonia, right lower lobe, non-severe; type 2 diabetes with hyperglycemia. Rationale: naming severity here makes the antibiotic choice below traceable to it.

Condition. Fair. Rationale: stable vital signs with a borderline saturation.

Vitals. Every [four] hours, with pulse oximetry each time. Rationale: his oxygen need is modest and stable; hourly checks would add burden without changing management.

Allergies. No known drug allergies, confirmed with the patient and the pharmacy record. Rationale: the beta-lactam order below depends on it.

Activity. Out of bed to a chair [three] times a day and walking in the hall with assistance as tolerated. Rationale: early mobility shortens stays in pneumonia and lowers his clot risk.

Nursing. Oxygen by nasal cannula, adjusted to hold his saturation between [92] and [96] percent; incentive spirometer use, [ten] breaths each waking hour; fingerstick glucose checks with each meal and once at night; report a saturation below [90] or a respiratory rate above [28]. Rationale: oxygen is ordered to a range, not a flow, so the nurse can reduce it as he improves without waiting for a new order.

Diet. Carbohydrate-consistent diet. Rationale: he is eating, and a consistent carbohydrate load makes insulin doses safer to set.

Intravenous fluids. Saline lock only. Rationale: he is drinking, and maintenance fluids add sodium and volume without benefit.

Medications. Ceftriaxone [1 g] intravenously every [24] hours plus azithromycin [500 mg] daily, the combination the ATS and IDSA guideline recommends for non-severe inpatient pneumonia without risk factors for resistant organisms (Metlay et al., 2019). The antibiotic plan will be reviewed at [48] hours for a switch to oral therapy once he is stable and eating, with a total course of at least [five] days. Enoxaparin [40 mg] subcutaneously daily for clot prevention: his Padua score is [4], with [3] points for reduced mobility and [1] for acute infection, which places him in the high-risk group (Barbar et al., 2010), and the ASH guideline supports pharmacologic prophylaxis for acutely ill medical inpatients at this risk (Schünemann et al., 2018). Basal insulin glargine [10] units at bedtime with correctional insulin; metformin held while he is acutely ill. Lisinopril continued at the home dose. Acetaminophen [650 mg] every [six] hours as needed for fever or pain.

Labs. Complete blood count and basic metabolic panel in the morning; hemoglobin A1c once. Rationale: a morning panel checks kidney function for enoxaparin dosing and the effect of illness on his glucose.

Special orders. Pneumococcal and influenza vaccine status reviewed before discharge; smoking status confirmed (he does not smoke). Rationale: prevention belongs in the admission, not only at follow-up.

What this part is doingEach rationale ties the order to a fact about this patient, not to pneumonia in general.

Part Two: Orders Left Out on Purpose

1. Blood cultures. Left out because his pneumonia is non-severe and he has no risk factors for MRSA or Pseudomonas; the guideline recommends against routine blood cultures in that group (Metlay et al., 2019). Condition that would add them: a turn to severe pneumonia or a new risk factor.

2. Sputum culture. Left out for the same reason and on the same guideline. Condition: severe disease, or prior MRSA or Pseudomonas.

3. Pneumococcal and Legionella urinary antigens. Left out because the guideline does not recommend them routinely for non-severe disease. Condition: severe pneumonia, or a Legionella outbreak or recent travel.

4. Corticosteroids. Left out because the guideline recommends against their routine use in non-severe community-acquired pneumonia, and steroids would worsen his glucose.

5. Telemetry. Left out because he has no cardiac indication; the AHA practice standards reserve continuous ECG monitoring for patients with a specific arrhythmia or ischemia risk (Sandau et al., 2017). Condition: new arrhythmia or chest pain suggesting ischemia.

6. Anaerobic coverage. Left out because nothing suggests aspiration or an abscess or empyema, and the guideline advises against adding it routinely for suspected aspiration.

7. Stress ulcer prophylaxis. Left out because he is not critically ill and has no bleeding risk factor that would justify acid suppression, which carries its own risks.

What this part is doingAn order withheld is still a decision, so each omission names the condition that would reverse it.

References

Barbar, S., Noventa, F., Rossetto, V., Ferrari, A., Brandolin, B., Perlati, M., De Bon, E., Tormene, D., Pagnan, A., & Prandoni, P. (2010). A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: The Padua Prediction Score. Journal of Thrombosis and Haemostasis, 8(11), 2450-2457. https://doi.org/10.1111/j.1538-7836.2010.04044.x

Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., Cooley, L. A., Dean, N. C., Fine, M. J., Flanders, S. A., Griffin, M. R., Metersky, M. L., Musher, D. M., Restrepo, M. I., & Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired pneumonia: An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine, 200(7), e45-e67. https://doi.org/10.1164/rccm.201908-1581ST

Sandau, K. E., Funk, M., Auerbach, A., Barsness, G. W., Blum, K., Cvach, M., Lampert, R., May, J. L., McDaniel, G. M., Perez, M. V., Sendelbach, S., Sommargren, C. E., & Wang, P. J. (2017). Update to practice standards for electrocardiographic monitoring in hospital settings: A scientific statement from the American Heart Association. Circulation, 136(19), e273-e344. https://doi.org/10.1161/CIR.0000000000000527

Schünemann, H. J., Cushman, M., Burnett, A. E., Kahn, S. R., Beyer-Westendorf, J., Spencer, F. A., Rezende, S. M., Zakai, N. A., Bauer, K. A., Dentali, F., Lansing, J., Balduzzi, S., Darzi, A., Morgano, G. P., Neumann, I., Nieuwlaat, R., Yepes-Nuñez, J. J., Zhang, Y., & Wiercioch, W. (2018). American Society of Hematology 2018 guidelines for management of venous thromboembolism: Prophylaxis for hospitalized and nonhospitalized medical patients. Blood Advances, 2(22), 3198-3225. https://doi.org/10.1182/bloodadvances.2018022954

What the NU650 Unit 6 assignment asks for

The Unit 6 assignment asks you to write a set of admission orders for an acutely ill adult and justify each one. You follow a standard structure or your hospital's order set, give every order with its rationale, cite evidence for the medication and prophylaxis choices and set a point at which each order will be reviewed. Many prompts also ask you to explain orders you chose not to write, since leaving something out is a decision. Three to four pages is typical. The orders should be specific to the patient's severity, risk factors and ability to eat and drink, not a generic set for the diagnosis. Write the rationale so a nurse reading the orders at night would understand why each one is there.

How this NU650 Unit 6 example is built

The example starts with a short case line giving the facts every order depends on: severity by CURB-65, the absence of MRSA and Pseudomonas risk factors, and the fact that he is drinking. Part one then takes the mnemonic in order, with each category written as the order followed by a rationale of one or two sentences. Medication orders carry the longest rationales, with sources and a 48-hour review for the antibiotics. Part two is a numbered list of seven omissions, each giving the reason and the condition that would reverse it. Sources are the community-acquired pneumonia guideline, the Padua score study, the ASH prophylaxis guideline and the AHA monitoring standards.

NU650 Unit 6 rubric: what earns full points

The Unit 6 rubric divides its points among completeness of the order set, appropriateness of each order, the quality of the rationale, use of evidence and clarity. Completeness is judged against the structure you chose, so a missing activity or diet order costs points. Appropriateness earns full credit when orders fit this patient, such as a saline lock for a man who is drinking. Rationale counts when it explains why, not what. Evidence is expected for antibiotics, prophylaxis and any test left out. The omissions section often earns more than students expect, because it shows judgment. Orders must be written clearly enough to be acted on.

Common NU650 Unit 6 mistakes, and how to avoid them

The most common mistake is writing every test and treatment the diagnosis might ever need, including blood cultures, steroids and telemetry for a non-severe pneumonia. Another is choosing antibiotics without checking for resistance risk factors. Students often order maintenance intravenous fluids for patients who are drinking. Clot prevention is sometimes ordered without a risk score to justify it. Oxygen is frequently written as a flow rather than a target. Some order sets forget glucose management in a patient with diabetes. And many papers never state when the antibiotic plan will be reviewed, which leaves the switch to oral therapy to chance. Check allergies before the antibiotic order, too, since the whole plan rests on that line.

Get an NU650 Unit 6 example written to your instructions

Inputs are the admission scenario from NU650 Unit 6, the rubric and any mnemonic or order format the section insists on. A first sample carries no charge and returns in 24-48h, written around a made-up admission, with every order justified, each omission backed by its guideline or Choosing Wisely source, and the conditions for reversing it named. 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 6 questions, answered

Does the sample have to use ADC VAAN DIMLS?

No. It uses whatever structure the prompt or the site's order set prescribes, whether a mnemonic, a problem-based layout or an electronic order-set template. The mnemonic appears in this sample because many acute care courses teach it for admissions. The rationale approach, one reason per order tied to the patient, works in any format.

Why explain orders that were not written?

Because declining an order is a clinical decision and graders often test it. A student who adds blood cultures, steroids and telemetry to every pneumonia admission shows habit rather than judgment. Naming the omission, the source behind it and the condition that would reverse it shows the reasoning an admitting clinician uses, which is what the unit tends to assess.

Are the doses in the sample safe to copy?

They are coursework placeholders in brackets, not prescriptions. What earns marks is the reasoning behind each order and the hour it is revisited. Real dosing turns on kidney function, weight, allergies and local resistance patterns, settled by a treating team with pharmacy input. The invented patient exists only to teach, so no order here transfers to anyone's care.

Where can I find a free NU650 Unit 6 sample paper?

The complete NU650 Unit 6 admission orders rationale is on this page, with twelve order categories, their reasons and seven orders left out on purpose. Orders for heart failure, cellulitis or another admission can be written free from your own prompt.

Which antibiotics does the NU650 Unit 6 sample order?

Ceftriaxone with azithromycin, the combination the 2019 ATS and IDSA guideline recommends for non-severe inpatient community-acquired pneumonia without risk factors for MRSA or Pseudomonas. The sample sets a 48-hour review for a switch to oral therapy.