| Course | NR 304 Health Assessment II |
|---|---|
| Week | 3 |
| Paper type | Abnormal findings report |
| Length | About 1,130 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 304 Week 3
Abnormal Findings Report: Redness Spreading From a Groin Incision Between 0800 and 1600 on the Third Day After Hernia Repair
Student Name
College of Nursing, Chamberlain University
NR 304: Health Assessment II
Instructor Name
Month Day, Year
Abnormal Findings Report: Redness Spreading From a Groin Incision Between 0800 and 1600 on the Third Day After Hernia Repair
The Deviation
At 1600 on postoperative day 3, the redness around Mr. W.'s right groin incision extended 18 millimeters beyond the lower edge of the incision, measured with a paper wound ruler along a line straight down from the midpoint of the incision. At 0800 the same day, the day nurse measured the same edge in the same way at 8 millimeters and marked the outer border of the redness with a skin marker. At 1600 the redness had crossed the marker line by 10 millimeters along most of its length. The redness has therefore spread 10 millimeters in 8 hours.
Mr. W. is a 63-year-old retired electrician who had an open repair of a right inguinal hernia three days ago. He is on a surgical unit because of a slow return of bowel function after the operation. He takes metformin and glipizide for type 2 diabetes.
The Finding in Full
Site: right groin, around a 7-centimeter incision running parallel to and about 2 centimeters above the crease of the groin, closed with skin staples.
Comparator: the 0800 entry by the day nurse, taken with the same paper ruler along the same line, and the skin-marker border she drew at that time.
Size of redness beyond the incision edge, 1600 (0800 in brackets): below the incision, 18 millimeters (8); above the incision, 12 millimeters (6); at the inner end, 9 millimeters (5); at the outer end, 10 millimeters (5).
Color: bright pink-red close to the incision, fading to pale pink at the outer border; at 0800 recorded as pale pink.
Warmth, back of the hand: warmer than the skin of the left groin at the same distance from the midline; at 0800 recorded as slightly warm.
Swelling: the skin around the lower half of the incision is raised and firm to light touch over an area about 3 by 2 centimeters; at 0800 recorded as no swelling.
Drainage: a spot of thin, cloudy, pale yellow fluid about 1 centimeter across on the gauze over the lower two staples; at 0800 the gauze was dry.
Staple line: edges of the incision together along its whole length; no gap between staples.
Tenderness: Mr. W. rates the incision at rest as a 5 (numeric scale, 0 to 10) at 1600, and says it is "sorer than this morning"; at 0800 he rated it a 2.
Duration: redness first recorded at 0800 today; at 2000 last night the evening nurse recorded the incision as edges together, no redness.
Related Figures
Temperature, oral, electronic: 38.1 degrees Celsius at 1600; 37.4 at 0800; 37.0 at 2000 last night.
Heart rate, radial, one full minute: 96 at 1600; 82 at 0800.
Respirations: 18 at 1600; 16 at 0800.
Blood pressure, left arm, lying: 128/76 at 1600; 134/78 at 0800.
Fingerstick glucose: 214 milligrams per deciliter at 1130, before lunch; 162 at 0700, before breakfast.
Ordinary findings from the same assessment: lungs, heart, abdomen and legs were examined at 1600 and matched the 0800 entries; bowel sounds heard in all four quadrants, and he passed gas at 1300; calves soft and not tender, equal in size.
What the Finding Raises
The spread of redness, together with new warmth, new swelling, cloudy drainage, increased tenderness and a temperature that has risen through the day, raises the question of an infection in the incision. The guideline on preventing infection after surgery published by the Centers for Disease Control and Prevention defines an infection of the incision's skin and tissue under it partly by these signs, including localized swelling, redness or heat, pain or tenderness, and drainage (Mangram et al., 1999). The student is not in a position to decide whether that is what is happening; that decision belongs to the surgical team, and it may depend on tests the student cannot order.
Mr. W.'s diabetes and the rise in his blood glucose over the morning are relevant context. The student records them as part of the report because they may matter to the surgical team, not because the student can say what the relationship is in this patient.
Action Taken
1605: marked the new outer border of the redness with a skin marker, dated and timed next to the line.
1610: reported the finding to the charge nurse and the primary nurse, giving the 1600 measurement and the 0800 measurement together, and the temperature at both times.
1620: the primary nurse paged the surgical resident with the same figures.
1625: swapped the gauze and kept the drainage sample on the old dressing in a bag, labeled, in case a culture is requested.
Next check: the student's shift ends at 1900; the handoff will ask the evening nurse to measure again at 2000 with the same ruler along the same line.
Reflection on Writing the Report
The first version of this report said the incision is red and more inflamed than this morning. Every word in that sentence is a judgment. Red has no size, inflamed is an interpretation, and more than this morning gives no figure for either time. Rewriting it required going back to the 0800 entry to find the earlier measurement, which was only possible because the day nurse had used a ruler and a skin marker. That is the real lesson of this week: a deviation only exists against an earlier figure taken the same way, and the report depends on the person before me having written that figure down.
The second lesson was about order. In the first draft the incision finding appeared halfway down the page, after the lungs and heart, because that was the order of the examination. Anyone reading quickly would have seen normal findings first and might have stopped. Moving the deviation to the first line was simple, and Bickley et al. (2021) describe the purpose of a clinical record as communicating to the next reader what is most important. The ordinary findings are still in the report, grouped together, because they are the evidence that the change is confined to the incision.
The third lesson was about instruments. Jarvis and Eckhardt (2024) recommend measuring lesions and wounds with a ruler and describing them in terms of size, color, and drainage, and this report shows why. The eye alone would have said the redness looked bigger. The ruler said by how much, where, and between which two times, and that is a claim another nurse can check at 2000.
References
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed.). Wolters Kluwer.
Jarvis, C., & Eckhardt, A. (2024). Physical examination and health assessment (9th ed.). Elsevier.
Mangram, A. J., Horan, T. C., Pearson, M. L., Silver, L. C., & Jarvis, W. R. (1999). Guideline for prevention of surgical site infection, 1999. Infection Control & Hospital Epidemiology, 20(4), 247-280. https://doi.org/10.1086/501620
The Chamberlain NR 304 Week 3 instructions
The Week 3 assignment asks you to document and report an abnormal finding, usually from a case or simulation. Expect to describe the finding precisely, compare it with an earlier baseline, include related data, state what it may indicate within your scope and describe the actions taken. Put the abnormal finding first, not halfway down a head-to-toe list. Measure with a tool and give the same tool and line for the comparison. Record how long the finding has been present by tracing back to the last normal entry. Keep description and interpretation in separate paragraphs. End with what was reported, to whom and when, plus the next check.
Inside the NR 304 Week 3 example
The report opens with one sentence: redness 18 millimeters beyond the lower edge at 1600, measured with a paper ruler, against 8 millimeters at 0800. Mr. W.'s background follows, including type 2 diabetes. The full finding is listed feature by feature with the 0800 figure in brackets, from four measured sides to drainage on the gauze and tenderness rising from 2 to 5. Related figures add temperature, heart rate and glucose readings. A separate section explains what the finding raises, citing Mangram et al. (1999), and stops at a question. Actions are logged from 1605 to 1625, ending with the handoff. The reflection rewrites red and inflamed into measurements.
NR 304 Week 3 rubric: what full points look like
Abnormal findings rubrics usually grade clarity and placement of the finding, precision of description, use of a comparator, relevant supporting data, appropriate interpretation within scope, timely reporting and reflection. Placement and precision carry the most weight, so the deviation leads the page with size, place, tool and earlier figure. The comparator is credited when it stays the same throughout. Supporting data scores when vital signs and glucose are given with their earlier values. Interpretation earns points when separated from description and limited to raising a question. Reporting is graded on who, what and when, all logged here. Measuring with a ruler instead of the eye shows the precision the course wants.
NR 304 Week 3 help from the desk
The most expensive line is a deviation recorded in the same voice as everything else, halfway down the page. Bare judgment words like high, poor or worse give no figure. A site given as the leg, a duration left out, description and interpretation folded together, a comparator that changes, figures taken different ways and a closing paragraph that requests nothing all cost points. If there is no earlier figure, say so and set a baseline now. Go only as far as raising a question in your interpretation. Include ordinary findings briefly to show what was checked. Pass along your case, and an abnormal findings report can be drafted with the deviation first.
Get a NR 304 Week 3 example written to your instructions
Send the Week 3 instructions and whatever reporting form your classroom issued, and a custom example is written into it, with a deviation reported at the level of precision this week rewards, inside 24 to 48 hours. The first one is free. Include the prompt's own wording for the abnormal finding, because the comparator has to be one your case can support.
More NR 304 papers and pre-licensure samples
- NR 304 Week 1: Symptom Timing Question Post
- NR 304 Week 2: Focused Ankle Exam Write-Up
- NR 304 Week 4: Pain Assessment Write-up
- NR 304 Week 5: Case Study Analysis
- NR 304 Week 6: Documentation Exercise
- NR 304 Week 7: Risk Assessment Write-up
- NR 304 Week 8: Comprehensive Assessment Paper
- NR 324 Week 3: Case Study Analysis
- NR 302 Week 3: Skin Assessment Write-Up
- NR 325 Week 3: Laboratory Trend Write-up
- NR 293 Week 3: Dosage Calculation Practice Set
NR 304 Week 3 questions, answered
What if I have nothing earlier to check the finding against?
Then you create the first entry and say so. Record what you found, the time you found it, and the conditions you took it under, then note that no earlier figure exists for this site. That sentence is worth marks because it tells the next reader that a repeat reading has something to be repeated against. A first measurement honestly labeled is far better than one implying a comparison that never happened.
How far can I go toward saying what the finding means?
Far enough to say what it raises and why it concerns you, and no further. The safe test is whether your sentence could be checked by somebody who was not there. A separated wound edge with its measurement can be checked. An infection cannot, at this stage, and reaching for the name usually costs the description that would have supported it anyway. Keep the two in separate sentences.
Does the report need the ordinary findings as well?
It needs them, briefly, and in one place. Their job is to show that the rest of the region was covered and that the deviation stands out against them rather than against nothing. What ruins the report is giving them the same weight as the finding, because the document then reads as a routine record and the reader has no way to see which line prompted it.
Where can I find a free NR 304 Week 3 sample paper?
The whole Week 3 report on Mr. W.'s spreading incision redness, with every feature against its 0800 figure and the timed actions, is printed further down this page.
How is the redness measured in the NR 304 Week 3 report?
With a paper wound ruler along a line straight down from the midpoint of the incision, the same ruler and line the day nurse used at 0800, plus a dated skin-marker border.