| Course | NR 226 Fundamentals: Patient Care |
|---|---|
| Week | 1 |
| Paper type | Discussion post with one reply |
| Length | About 530 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 226 Week 1
Week 1 Discussion: A Nursing Action and What It Is For
Turning an 81-Year-Old Man Off His Sacrum at 0200, and What the Evidence Does and Does Not Say About Every Two Hours
Initial Post
The action I chose is turning a patient who has been lying still. On my clinical unit last week, my patient was an 81-year-old man in his third day of treatment for pneumonia, too tired to change position on his own, with a reddened area over his sacrum that the day nurse had described as a stage 2 pressure injury. His treatment, antibiotics and oxygen, had already been decided by the provider. Turning him every two hours was nursing's part, and nobody else on the team would have done it.
What turning is for: it moves pressure off the skin over bony points, like the sacrum and heels, so blood can flow back into tissue that has been squeezed between bone and mattress. If nobody had turned him overnight, the most likely result would be that his stage 2 injury, which is an open, shallow wound, deepened into a stage 3 or 4, which can take months to heal and can become infected. In a frail 81-year-old recovering from pneumonia, that is a new illness caused by the hospital stay.
The contested part of my claim is the "every two hours." I assumed it was proven. Gillespie et al. (2020), in a Cochrane review of repositioning to prevent pressure injuries in adults, found that the evidence on how often to reposition, and in what position, was of low or very low certainty, and that it remains unclear whether turning every three or four hours is any worse than every two. So the evidence supports turning; it does not strongly support the exact interval. On my unit the two-hour schedule is the policy, and for my patient, who already had an injury, I would not stretch it.
The order test: I ran through what would happen if I did the other things first. At 0200 he also needed his oxygen checked and a sip of water. None of those gets worse by waiting five minutes, but his sacrum had been bearing his weight since midnight. So I turned him first, onto his left side with a pillow behind his back and another between his knees, checked the reddened area, and then gave him the water sitting up.
My question for the class: if the evidence on turning frequency is weak, would you turn a patient without an injury every three hours instead of two, to let them sleep?
Reply to a Classmate
Destiny, your post on checking whether a patient can swallow before the tray is put down made me think of my patient. He was tired enough that I would have wanted his swallow checked too, and I did not think of it. If he had been turned onto his side at 0200 and given water lying flat, both of our actions would have met in one risk. Who on your unit does the swallow screen, and does the night shift repeat it when a patient becomes more tired?
References
Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2020). Repositioning for pressure injury prevention in adults. Cochrane Database of Systematic Reviews, (6), Article CD009958. https://doi.org/10.1002/14651858.CD009958.pub3
Reading the NR 226 Week 1 instructions
The first NR 226 discussion asks you to describe an independent nursing action, one a nurse can take without a provider's order, and explain its purpose. Expect the prompt to ask what would happen if the action were not done and, often, to support the claim with a scholarly source. Plan on one initial post and at least one classmate reply, each due on the days the course calendar sets. The prompt is testing whether you can separate nursing's own decisions from prescribed treatment, so an action that depends on a medication order misses the point. If you have not been in clinical yet, choose an action from the skills lab. Replies should add a related action or question.
How this NR 226 Week 1 example is built
The post names its action in the first line and gives the patient: 81, day three of pneumonia, too tired to move, with redness over his sacrum. A paragraph explains the mechanism, pressure off bony points so blood can return. The writer then admits that every two hours was assumed, and cites Gillespie et al. (2020), whose Cochrane review found weak evidence on frequency. An order test follows, comparing turning with checking oxygen and offering water at 0200. The closing question asks whether classmates would turn every three hours to let a patient sleep. The reply to Destiny connects her swallow check to the same patient and passes the question to the next shift.
Reading the NR 226 Week 1 grading rubric
The NR 226 discussion rubric usually weighs the answer to the prompt, the use of evidence, the reply and the mechanics. The answer row rewards an action a nurse owns, a stated purpose and a consequence if it is skipped, all of which appear in the first two paragraphs. Evidence counts most when it is placed under a claim someone could dispute; here the Cochrane review tests the two-hour schedule instead of decorating an obvious point. The reply earns credit for linking a classmate's action to the writer's own patient. Mechanics cover a complete reference, posting on time and a readable length. Answering every part of a multi-part prompt protects points that are easy to miss.
NR 226 Week 1 help: mistakes that cost points
The costliest posts are built from the reading alone: they define the nursing process, endorse it and never name an action. Another loses points by choosing an action that waits on a prescription, which reverses the week's central distinction. Claims of improvement with no mechanism, citations attached to sentences nobody would dispute and multi-part prompts answered in one part all cost marks. Replies that only agree add nothing. A final line so complete that the thread has nowhere to go weakens discussion scores too. If you need a patient, use one from the skills lab or a family member's stay. Send the prompt and an action you are considering for a draft built around it.
Get a NR 226 Week 1 example written to your instructions
Send the Week 1 prompt as your classroom worded it, plus the patient situation if one was supplied, and a custom post is written to that prompt and returned inside 24 to 48 hours. The first one is free. If your section grades replies, tell us how many are expected and those get drafted too.
More NR 226 papers and pre-licensure samples
- NR 226 Week 2: Assessment Data Write-up
- NR 226 Week 3: Nursing Diagnosis Exercise
- NR 226 Week 4: Care Plan
- NR 226 Week 5: Concept Map
- NR 226 Week 6: Priority-setting Case
- NR 226 Week 7: Discharge Teaching Plan
- NR 226 Week 8: Reflection
- NR 228 Week 1: Discussion Post
- NR 224 Week 1: One Small Safety Action Post
- NR 283 Week 1: Discussion Post
- NR 222 Week 1: What Is Health? Discussion Post
NR 226 Week 1 questions, answered
I have not been in clinical yet. What do I write about?
Whatever the week supplies, and where nothing is supplied, an ordinary situation described plainly. The post is marked on the reasoning rather than on how much you have seen, and an instructor teaching a first term expects somebody who has not yet stood at a bedside. Inexperience shows up as vagueness rather than as a shortage of patients, so keep the example small and specific.
Does a discussion post need citations?
In most sections yes, and where you put them decides more than how many there are. Put the reference against the sentence a reader could argue with, usually the claim that the nursing action changed what happened next. A citation parked under a definition supports something nobody questioned and reads as decoration. Check whether your classroom expects a reference in replies as well, since a good number of them do.
How is this different from what the physician decides?
Authority, and the quick check is whether anything has to be written before you can act. Where an action waits on a prescription it belongs inside the treatment plan and is not what this prompt is asking for. Repositioning, hydration, teaching and watching for change do not wait on anyone. That same check governs the diagnosis you write in Week 3, so it is worth settling now.
Where can I find a free NR 226 Week 1 sample paper?
The complete Week 1 post on turning an 81-year-old man at 0200, with the Cochrane review on repositioning and the reply to Destiny, is printed on this page.
What does the NR 226 Week 1 post say about turning every two hours?
It notes that Gillespie and colleagues' 2020 Cochrane review found the evidence on how often to reposition weak, so the two-hour rule is presented as practice rather than proven fact.