| Course | NU673 PMHNP Diagnosis and Management Across the Lifespan I |
|---|---|
| Unit | Unit 7 |
| Paper type | Initial treatment plan |
| Length | About 900 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU673 Unit 7
Two Months of Daily Ratings and a Blood Pressure of 146/94: An Initial Treatment Plan for Premenstrual Dysphoric Disorder in a 41-Year-Old Claims Adjuster
[Student Name]
Purdue University Global
NU673: PMHNP Diagnosis and Management Across the Lifespan I
Unit 7 Initial Treatment Plan
[Instructor Name]
[Date]
The patient is composite; ratings, values and doses are bracketed.
Summary of the Workup
Ms. [V.] is a [41]-year-old insurance claims adjuster who reports that for about a week before each period she becomes irritable to the point of shouting at her teenage son, cries at work, feels hopeless and "out of control," and sleeps poorly. The symptoms have worsened over [three] years and have led to [two] written warnings at work for conflicts with colleagues. She is otherwise well.
The workup and its results:
1. Prospective daily ratings for two menstrual cycles using the Daily Record of Severity of Problems, a measure with good reliability and validity for premenstrual symptoms (Endicott et al., 2006). Result: marked symptoms on days [minus 7] to [plus 2] of both cycles, with near-normal ratings in the follicular phase.
2. Thyroid function. Result: TSH [1.8] mIU/L, normal.
3. Complete blood count and ferritin. Result: normal.
4. Screening for a persistent mood or anxiety disorder that worsens premenstrually. Result: PHQ-9 of [3] and GAD-7 of [4] in the follicular phase; no history of mania.
5. Pregnancy test. Result: negative. She uses a copper intrauterine device and does not want another pregnancy.
6. Blood pressure. Result: [146/94] and [144/92] at two visits a week apart; she has no other cardiovascular risk factors and does not smoke.
These results support a diagnosis of premenstrual dysphoric disorder: symptoms confined to the luteal phase, confirmed prospectively, severe enough to impair work and relationships, and not better explained by another condition. Prospective confirmation matters, since retrospective reports alone overestimate the disorder (Yonkers et al., 2008).
Element 1: A Selective Serotonin Reuptake Inhibitor
Permitted by: the confirmed diagnosis, and her blood pressure, which argues against the main hormonal alternative.
A Cochrane review of [31] randomized trials found that selective serotonin reuptake inhibitors reduced premenstrual symptoms more than placebo, whether taken throughout the cycle or only in the luteal phase, with nausea and fatigue the most common side effects (Marjoribanks et al., 2013). Sertraline [50] mg daily will be started, taken continuously for the first cycle so that she can judge tolerability, then switched to luteal-phase dosing from day [14] to the start of her period if she prefers, since her cycles are regular.
The SSRI is chosen not only because it works but because the other first-line option was ruled out by a number on her chart.
Element 2: Why Not a Combined Hormonal Contraceptive
Permitted by: nothing; ruled out by the blood pressure readings.
A combined oral contraceptive containing drospirenone is an approved treatment for premenstrual dysphoric disorder. However, the U.S. Medical Eligibility Criteria classify combined hormonal contraception in women with systolic pressure of 140 to 159 or diastolic pressure of 90 to 99 as a condition in which the risks usually outweigh the benefits (Nguyen et al., 2024). Her two readings fall in that range. She also already has effective contraception with her copper device. The option will be reconsidered only if her blood pressure is controlled and the SSRI fails.
Element 3: Blood Pressure Follow-Up
Permitted by: the two elevated readings, which are a finding in their own right. She was referred back to her primary care clinician for confirmation with home monitoring and treatment if confirmed. Sertraline does not usually raise blood pressure, so it can start in parallel.
Element 4: Continued Daily Ratings
Permitted by: the baseline ratings, which provide a comparison. She will continue the daily record for the first [two] treated cycles. Success is defined in advance as a reduction of at least [50] percent in her luteal-phase ratings compared with baseline and no further written warnings at work.
Element 5: Psychological Support
Permitted by: the pattern of symptoms, which includes predictable days of risk. Cognitive behavioral strategies, including planning lighter workloads on predicted high-risk days and a script for leaving a tense conversation, will be offered in [four] sessions. She and her son will be given a plain explanation of the diagnosis, with her consent.
What She Was Told
The plan was explained to her in plain terms. The daily ratings show that her symptoms follow her cycle, which confirms a recognized, treatable condition rather than a flaw in her character. The first medicine is one that acts quickly in this condition, often within the first cycle, unlike its slower effect in depression, and she can choose later whether to take it all month or only in the second half of her cycle. The birth control pill that is sometimes used was set aside because of her blood pressure, and her blood pressure itself needs attention from her primary care clinician. She asked whether the medicine would change her personality; she was told that most people notice fewer bad days rather than a different self, and that nausea in the first week is the most common side effect.
Follow-Up
Review after one full treated cycle, at about [five] weeks, to assess response, side effects and her preference for continuous or luteal dosing. If there is no meaningful improvement after [two] cycles at an adequate dose, a different SSRI or a higher dose will be considered.
References
Endicott, J., Nee, J., & Harrison, W. (2006). Daily Record of Severity of Problems (DRSP): Reliability and validity. Archives of Women's Mental Health, 9(1), 41-49. https://doi.org/10.1007/s00737-005-0103-y
Marjoribanks, J., Brown, J., O'Brien, P. M. S., & Wyatt, K. (2013). Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database of Systematic Reviews, 2013(6), Article CD001396. https://doi.org/10.1002/14651858.CD001396.pub3
Nguyen, A. T., Curtis, K. M., Tepper, N. K., Kortsmit, K., Brittain, A. W., Snyder, E. M., Cohen, M. A., Zapata, L. B., & Whiteman, M. K. (2024). U.S. medical eligibility criteria for contraceptive use, 2024. MMWR Recommendations and Reports, 73(4), 1-126. https://doi.org/10.15585/mmwr.rr7304a1
Yonkers, K. A., O'Brien, P. M. S., & Eriksson, E. (2008). Premenstrual syndrome. The Lancet, 371(9619), 1200-1210. https://doi.org/10.1016/S0140-6736(08)60527-9
Reading the NU 673 Unit 7 instructions
For Unit 7 you write the first treatment plan once the workup is complete. Prompts usually ask you to summarize the workup and its results, state the diagnosis, and build a plan in which each element is justified by a finding, with alternatives considered and rejected for stated reasons. Expect three to five pages, drawing on guidelines and trials. Graders reward plans that visibly depend on the workup, that address incidental findings responsibly, and that define success in advance. Including what the patient was told and what she chose, along with a follow-up date and a next step if the first choice fails, completes the plan and shows shared decision making.
Inside the NU673 Unit 7 example
The workup is summarized in six numbered results, including two cycles of the Daily Record of Severity of Problems and two blood pressure readings. The diagnosis follows, with a note from Yonkers on why prospective ratings matter. Five elements then follow, each opening with what permits it. The SSRI element cites the Cochrane review and gives the dosing plan, with a highlighted sentence tying the choice to her blood pressure. The contraceptive element explains the category in the eligibility criteria. The blood pressure is referred to primary care, daily ratings continue with a predefined success threshold, and brief cognitive behavioral support is added. A plain-language section and a follow-up plan close it.
Where the points sit in the NU673 Unit 7 rubric
Initial plans are generally graded on the workup summary, the link between findings and plan elements, evidence, handling of incidental findings and patient involvement. The summary earns full points when results are listed with their interpretation. The link row rewards elements that name the finding permitting them, and alternatives that name the finding excluding them. Evidence points go to trials, reviews and guidelines matched to each choice. Incidental findings, here blood pressure, should be referred and shown not to delay the psychiatric plan. Patient involvement is judged on whether her questions and choices, such as luteal or continuous dosing, appear in the plan and the follow-up. Clear writing counts too.
Common NU673 Unit 7 mistakes, and how to avoid them
A common mistake is diagnosing the disorder from retrospective reports without prospective daily ratings. Another is offering a combined hormonal contraceptive without checking blood pressure against eligibility criteria. Students often forget to screen for a persistent mood or anxiety disorder that worsens before periods, which is treated differently. Some plans ignore the incidental blood pressure or delay the psychiatric plan because of it. Others define success vaguely. And plans that never explain the diagnosis to the patient in plain terms miss a chance to reduce the shame and conflict she described, which were part of why she came for help in the first place. Include the follow-up date in the plan.
Get an NU673 Unit 7 example written to your instructions
Send the full Unit 7 case from your NU673 section, workup results included, along with the rubric; an initial plan leans entirely on the workup beneath it. Free the first time and ready in 24-48h, the plan traces every element to a finding, gives reasons for what was set aside and fixes response targets before treatment begins. 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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NU673 Unit 7 questions, answered
What should the plan do with an abnormal result unrelated to the diagnosis?
Record it, say who will follow it up, and show whether it affects the psychiatric plan. An elevated blood pressure belongs to primary care, but it can still shape which medication is reasonable. Ignoring the result reads as inattention, while treating it inside a psychiatric plan oversteps the role.
How specific should response targets be?
Specific enough to check. Name the instrument, give the starting score, and state the figures that define response and remission, with a source for those definitions. Words such as improvement or fewer symptoms cannot be evaluated at follow-up, and later assignments in this course usually expect to test the plan against its own targets.
Where can I find a free NU673 Unit 7 sample paper?
The full NU673 Unit 7 initial treatment plan appears on this page, with the workup results, the diagnosis, five plan elements each tied to a finding, what she was told and the follow-up, plus four references. Send your own workup results and a plan can be built from them.
Why was a birth control pill not chosen in NU673 Unit 7?
Her blood pressure measured 146/94 and 144/92 at two visits. The U.S. Medical Eligibility Criteria classify combined hormonal contraception at that level as a condition in which risks usually outweigh benefits, and she already had a copper intrauterine device.
How is PMDD confirmed in NU673 Unit 7?
By two cycles of prospective daily ratings showing marked symptoms in the week before her period and near-normal ratings after it, together with normal thyroid tests and low follicular-phase depression and anxiety scores that rule out a persistent disorder.