| Course | NR 224 Fundamentals: Skills |
|---|---|
| Week | 7 |
| Paper type | Charting exercise |
| Length | About 1,090 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 224 Week 7
Charting Exercise: One Low Blood Sugar at 0610, Written Twice, Once as a Story and Once as a Record
Student Name
College of Nursing, Chamberlain University
NR 224: Fundamentals: Skills
Instructor Name
Month Day, Year
Charting Exercise: One Low Blood Sugar at 0610, Written Twice, Once as a Story and Once as a Record
The Event
The exercise gives an event to be charted. Mrs. L., 67, admitted with a foot infection, has type 2 diabetes and takes insulin glargine at bedtime and mealtime insulin by scale. At 0610 she calls because she feels shaky. The exercise asks for a narrative nursing note. I wrote it twice: first the way I would naturally tell it, then the way a record should read. The comparison is the point of the exercise. Details are composite.
The American Diabetes Association's hospital standards recommend that each hospital adopt a protocol for managing hypoglycemia and that episodes be documented in the medical record and tracked (ElSayed et al., 2024). Tracking only works if the note records times, values, actions and responses in a form someone else can read and count.
Version One, as a Story
"Early this morning the patient called because she felt shaky and anxious. Her blood sugar was low so I gave her juice per protocol. She seemed to feel better after a while and her sugar came back up. She was probably low because she didn't eat much dinner. Will continue to monitor."
This version is not false, but it cannot be checked. "Early this morning" could be any time before breakfast. "Low" is a judgment, not a value. "Juice per protocol" does not say how much. "Seemed to feel better" speaks for her. "Came back up" has no number. The cause is stated as fact without evidence. And "will continue to monitor" says nothing about what or when.
Version Two, as a Record
0610 Pt called; states "I feel shaky and my heart is pounding." Diaphoretic, alert, oriented x4. Capillary glucose 58 mg/dL (meter 2, right ring finger).
0612 120 mL apple juice (15 g carbohydrate) given per hypoglycemia protocol; pt drank all.
0627 Capillary glucose 81 mg/dL. Pt states "I feel better, not shaky now." Skin dry. HR 84.
0630 Breakfast tray requested early; charge RN informed. Provider paged re: 0610 glucose and overnight trend.
0645 Provider returned call; order received to reduce glargine from 24 units to 20 units tonight. Read back and confirmed.
0700 Pt eating breakfast, ate approx. 75% of tray. Capillary glucose 112 mg/dL.
Supporting data (entered separately, not as a conclusion): dinner intake last evening charted as 25% of tray; glargine 24 units given at 2100; 2200 glucose 142 mg/dL.
Time Is Attached, Not Implied
In the story, time is implied by the order of the sentences. In the record, every event has its own time. That matters for two reasons. The protocol requires a recheck 15 minutes after treatment, and only the times show that it happened: juice at 0612, recheck at 0627. And anyone reviewing the event later, including the provider deciding on tonight's insulin, needs to know how long she was low and how quickly she recovered.
Times also show gaps, and gaps are information.
Seen, Then Concluded
The story says she was low "because she didn't eat much dinner." That may be true, but it is a conclusion, and it arrived in the note before any evidence for it. In the record, the evidence is entered as data: dinner intake 25%, glargine given at 2100, bedtime glucose 142. The conclusion is left for the provider, who changed the insulin dose after seeing the same data. If I had written the cause as fact and been wrong, for example if she had also been given a mealtime dose she did not eat, the next nurse would have read my guess as a finding.
The Patient Speaks in Quotation Marks
The story says she "felt shaky and anxious" and "seemed to feel better." "Anxious" was my word, not hers; she said her heart was pounding. "Seemed to feel better" is my impression. The record gives her words in quotation marks, "I feel shaky and my heart is pounding" and "I feel better, not shaky now," and puts my observations, diaphoretic skin at 0610 and dry skin at 0627, beside them as separate data. Her words and my findings agree, which makes the record stronger than either alone.
Action and Response Are One Unit
Each action in the record is followed by its result: juice at 0612, glucose 81 and her report at 0627; provider paged at 0630, order received at 0645. An action charted without its response leaves the reader not knowing whether it worked. "Will continue to monitor" is replaced by a specific next check: the 0700 glucose with breakfast. The record also uses language the unit's record already uses, capillary glucose rather than "sugar," "per hypoglycemia protocol" rather than a description of the protocol, so it reads the same way as every other entry and can be searched and counted.
What the Record Leaves Out on Purpose
Some things belong in neither version. The story I first drafted had a sentence I deleted before writing it down: "Patient did not follow her diabetic diet at dinner." It judges her, it is not supported by anything I saw, and it would follow her through her admission as a label. Her tray was 25% eaten; that is the fact, and it is in the record. Why she ate so little, whether nausea from her antibiotics, dislike of the food or pain, is a question for the next conversation with her, not a conclusion for the chart.
The record also leaves out my own feelings about the event and any comment about the previous shift's insulin dose. If I thought the bedtime dose was too high given her dinner intake, the place to say so is the conversation with the provider, which the record shows happened at 0630, not an aside in the note.
Finally, if any of these entries had been written after the fact, for example if I had been with another patient and charted the 0612 juice at 0700, the entry would be marked as a late entry with the actual time of charting, and the time of the event would stay as 0612. Filling in a time as if it were written in the moment is the charting version of copying a paraphrase: the content may be true, but the record claims something it cannot show.
References
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Galindo, R. J., Hilliard, M. E., Johnson, E. L., Khunti, K., Lingvay, I., Matfin, G., McCoy, R. G., Perry, M. L., Pilla, S. J., Polsky, S., Prahalad, P., Pratley, R. E., Segal, A. R., . . . Gabbay, R. A. (2024). 16. Diabetes care in the hospital: Standards of care in diabetes-2024. Diabetes Care, 47(Suppl. 1), S295-S306. https://doi.org/10.2337/dc24-S016
What the NR 224 Week 7 assignment asks for
The Week 7 assignment asks you to document a patient event, often a change in condition, using a charting format your section names, such as narrative, focus or SOAP-style notes. Expect the instructions to supply the scenario and ask for accurate, objective, timed entries with the patient's words quoted. A short APA reflection or rationale may accompany the charting, with a source on documentation or the condition. The exercise rewards entries that pair each action with its response and keep observations separate from conclusions. Opinion and judgmental words about the patient lose points. Late entries, if any, must be marked as late. Only abbreviations your school approves should appear.
Inside the NR 224 Week 7 example
The paper opens with the event and the ADA hospital standards from ElSayed et al. (2024), which call for documenting and tracking hypoglycemia. Version one, the story, is shown in quotation marks and then taken apart phrase by phrase. Version two, the record, lists timed entries from 0610 to 0700, each with a value, the patient's words in quotation marks and the actions and responses. Supporting data on dinner intake and the 24-unit glargine dose sit separately. Following sections explain attached times, observations before conclusions, quoted words and action paired with response. The last section removes a judgmental sentence about her diet and explains how late entries are marked. Every line could be audited later.
NR 224 Week 7 rubric: what full points look like
Charting exercises are usually graded on accuracy, objectivity, timeliness, completeness and use of approved terms, sometimes with a rationale section in APA. Objectivity carries heavy weight, so the record quotes the patient and keeps conclusions out of the entries. Timeliness scores when each event has its own time and the recheck interval is visible. Completeness means each action has a response and each abnormal value has a notification. Approved abbreviations matter, and the sample uses common, safe ones. The rationale earns its row by tying the format to a published standard. Showing the weak version first lets the grader see the improvement criteria met one by one. Correct use of mg/dL and times in 24-hour form also helps.
NR 224 Week 7 help from the desk
Opinion inside the record costs the most: words like difficult, anxious or non-compliant hand the next reader a judgment instead of a fact. A gap in time with nothing explaining it reads as care that stopped. Conclusions with no observations behind them lose points. Abbreviations your section has not approved, paraphrased patient words, entries charted before a medication was given and abnormal values nobody was told about are all frequent deductions. Mistakes are corrected according to your facility's policy, never erased. Abbreviations seen on placement may not be approved in class. Pass along the event your instructor supplied, along with the charting format required, and a model record can be written for that 0610-style event in the same timed form.
Get a NR 224 Week 7 example written to your instructions
Send the charting exercise and the rubric, plus any forms or approved abbreviation list your section publishes, and a custom NR 224 example is written to them and returned inside 24 to 48 hours, the first one free. Record layouts differ sharply between classrooms, so an example built on your own template is far more use than one built on ours.
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NR 224 Week 7 questions, answered
Why is opinion such a problem in a note?
Because a record is read by people who will act on it. Calling somebody difficult tells the next reader nothing they can use, and it shapes how the patient is treated before anybody has met them. Writing what was said and what was seen leaves that reader free to judge, which is the whole design.
What do I do about a mistake in the record?
Whatever your classroom teaches, and the principle is the same everywhere: corrections are added, never disappeared. A late entry is labeled as one and carries both moments, the time of the event and the time of writing. A record that has quietly changed is worth less than one showing plainly that it was corrected.
Can I use the abbreviations I see on placement?
Only the ones your section approves. Sites carry local shorthand that means nothing elsewhere, and some of it appears on do-not-use lists for good reasons. An assignment marked against a published list loses points for anything outside it, however ordinary the abbreviation looks where you have seen it written.
Where can I find a free NR 224 Week 7 sample paper?
The full Week 7 charting exercise, with the story version, the timed record from 0610 to 0700 and the reasons behind each entry, is shown on this page.
What glucose values are charted in the NR 224 Week 7 example?
The record shows 58 mg/dL at 0610, 81 mg/dL at 0627 after 120 mL of apple juice and 112 mg/dL at 0700 with breakfast, each with its time and the patient's words.