| Course | NU652 AGACNP Acute Care Diagnosis and Management II |
|---|---|
| Unit | Unit 6 |
| Paper type | Consultation request letter |
| Length | About 670 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU652 Unit 6
Can the Gastroduodenal Artery Be Embolized Today? A Consultation Request Letter for a Posterior Duodenal Ulcer That Rebled After Two Endoscopies
[Student Name]
Purdue University Global
NU652: AGACNP Acute Care Diagnosis and Management II
Unit 6 Consultation Request Letter
[Instructor Name]
[Date]
The patient is composite; values, doses and times are bracketed, and clinicians are named by role.
Letter
To: Interventional Radiology, on-call attending Copy: General Surgery, on-call attending; Gastroenterology From: Hospital medicine team, AGACNP student on behalf of the attending Date and time: [Day 2], [14:20] Patient: Mr. [R.], [74] years old, medical ward bed [12]
Question: Is Mr. [R.] a candidate for transcatheter embolization of the gastroduodenal artery today, ideally within the next [two to three] hours, for a posterior duodenal bulb ulcer that has rebled after two endoscopic treatments?
Bleeding history: He was admitted on [Day 0] with melena and a hemoglobin of [7.1] g/dL. Endoscopy that evening showed a [12] mm ulcer on the posterior wall of the duodenal bulb with a visible vessel, treated with dilute epinephrine and [three] clips. On [Day 1] at [22:00] he vomited fresh blood, with a pulse of [118] and a hemoglobin of [6.4]. A second endoscopy at [01:30] found active oozing from the same vessel; [two] more clips were placed but the endoscopist documented that the vessel could not be secured because of its position and the scarred tissue around it. At [12:40] today he passed a large maroon stool and his hemoglobin fell from [8.3] to [7.0] despite [four] units of red cells in total. Two endoscopic attempts have failed on a vessel that sits over the gastroduodenal artery, and the team believes a third attempt is unlikely to succeed.
Current status: pulse [106], blood pressure [108/64] on no vasopressors, alert. Intravenous pantoprazole infusion running. [Two] large-bore intravenous lines. Type and crossmatch for [four] more units.
Procedural safety information: creatinine [1.3] mg/dL, estimated GFR [54]; no contrast allergy; iodinated contrast was not given this admission. Platelets [168,000]; INR [1.2]. He takes aspirin [81 mg] for a coronary stent placed [four] years ago, held since admission; no anticoagulant. He can lie flat. Weight [82] kg.
Why embolization now: The ACG guideline suggests repeat endoscopy for recurrent bleeding and, when endoscopic therapy fails, transcatheter embolization (Laine et al., 2021). Surgery was the traditional alternative after failed endoscopic control, and it carries higher risk in older patients with comorbidities (Lau et al., 1999). Surgery has been informed and has seen him; they agree that embolization is the preferred next step and will operate if embolization is not possible or fails.
Who does what:
1. Hospital medicine: transfusion and resuscitation, consent discussion with the patient and his daughter, holding aspirin, and transfer to intensive care if he becomes unstable.
2. Interventional radiology: decision on embolization, timing and consent for the procedure.
3. Gastroenterology: available for repeat endoscopy only if requested by radiology or surgery.
4. Surgery: standby for operation if embolization fails.
Contact: the team can be reached at [pager 4471]; the attending is [Dr. N.]. We will call you at [14:40] if we have not heard back, since his next hemoglobin is due at [15:00].
Notes on the Letter
The letter is ordered by what the reader must decide, not by how the admission unfolded. The history shrinks to the three facts that matter for embolization: where the ulcer sits over the artery, the two failed endoscopic attempts and how fast he is losing blood. Procedural safety data sit together so the radiologist can scan them for contrast risk, bleeding risk and positioning in a single paragraph.
The section on roles exists because consultations fail most often at handoffs between services. A well-known set of principles for effective consultation begins with a clear question and a stated urgency, and asks for honest communication about what each party will do (Goldman et al., 1983). Naming who holds each task, and when the requesting team will call back, applies those principles from the requesting side.
References
Goldman, L., Lee, T., & Rudd, P. (1983). Ten commandments for effective consultations. Archives of Internal Medicine, 143(9), 1753-1755. https://doi.org/10.1001/archinte.1983.00350090131022
Laine, L., Barkun, A. N., Saltzman, J. R., Martel, M., & Leontiadis, G. I. (2021). ACG clinical guideline: Upper gastrointestinal and ulcer bleeding. The American Journal of Gastroenterology, 116(5), 899-917. https://doi.org/10.14309/ajg.0000000000001245
Lau, J. Y. W., Sung, J. J. Y., Lam, Y.-H., Chan, A. C. W., Ng, E. K. W., Lee, D. W. H., Chan, F. K. L., Suen, R. C. Y., & Chung, S. C. S. (1999). Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. New England Journal of Medicine, 340(10), 751-756. https://doi.org/10.1056/NEJM199903113401002
NU652 Unit 6 instructions, in plain terms
The Unit 6 assignment asks you to write a consultation request to a specialist for an acutely ill patient. You state a specific question and its urgency, summarize the relevant history, give the data the consultant needs to decide, explain why you are asking and make clear who is responsible for what. The letter is usually one page. It should be written for the consultant's decision, not for your own record, so anything the consultant does not need is left out. Most sections expect a source supporting the request, such as a guideline recommending the procedure after a failed first treatment. Write it so the consultant can answer the question from the first paragraph alone if paged in the middle of a procedure.
How this NU652 Unit 6 example is built
The example opens with routing details and the question in a single sentence with a time frame. The bleeding history follows in a compact paragraph that includes the ulcer's position over the artery, the two failed endoscopies and the hemoglobin trend. Current status and procedural safety data come next, grouped for scanning. A short paragraph explains why embolization is the next step, citing the ACG guideline and a trial of surgery after failed endoscopic control. A numbered list assigns tasks across four services. The letter closes with a contact and a time for a follow-up call, and two notes explain its order.
NU652 Unit 6 rubric: what earns full points
The Unit 6 rubric usually awards points for the clarity of the question, the relevance of the information, the rationale, the division of responsibilities and professional communication. The question earns full credit when it is specific and answerable, with urgency stated. Relevance is judged on whether the letter includes what the consultant needs and leaves out what they do not. The rationale counts when it cites evidence for the request. Responsibilities must be clear, since consultations fail at handoffs. Professional tone and concise writing matter, and a letter that runs past a page usually loses points for clarity. Graders also check that the letter is signed with a role and a way to reach the team.
NU652 Unit 6 help: mistakes that cost points
The most common mistake is burying the question at the end of a long history. Another is asking a vague question, such as please evaluate, that the consultant cannot answer. Students often leave out safety data, such as kidney function and contrast allergy, which the consultant must then find. Some letters recommend the procedure as if the decision were theirs to make. Many forget to say who is doing what while the consultant decides. And an urgent request without a time for follow-up can sit unanswered, so name when you will call back. Read it once as the radiologist would, and cut anything that does not help that decision.
Get an NU652 Unit 6 example written to your instructions
Consult letters here often go to pulmonology, cardiology or nephrology rather than radiology, and the specialty changes what belongs in the safety paragraph. Name the consultant and the case, attach the rubric, and the first letter written to them costs nothing and returns within 24-48h, its question standing in the opening line. 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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NU652 Unit 6 questions, answered
Should the letter recommend the procedure or just ask about it?
Ask, with a reason. The consultant owns the decision about whether and how to intervene, so the sample frames embolization as a question and states why the team is asking now. A letter that orders the procedure oversteps; one that asks nothing specific wastes the consultant's time. The strongest requests sit between those, proposing an option and inviting judgment.
Where can I find a free NU652 Unit 6 sample paper?
The complete NU652 Unit 6 consultation request letter is on this page, with the question, bleeding history, safety data, rationale and division of tasks. If your consult goes to a different service, a free letter can be written from your case.
How long should the NU652 Unit 6 letter be?
One page. The sample's letter runs about 500 words because it carries a detailed bleeding history and four services' roles; a simpler request can be shorter, as long as the question and safety data come first.
Should the NU652 Unit 6 letter recommend embolization?
It asks whether embolization is possible and explains why the team thinks it is the next step, citing the guideline, but the decision belongs to the radiologist. Framing the request as a question respects that and gets a faster answer.
Why include aspirin and platelets in the NU652 Unit 6 letter?
Because they bear directly on the procedure's safety. The radiologist needs bleeding risk, kidney function, contrast allergy and whether the patient can lie flat before agreeing to an urgent embolization.