| Course | NR 341 Complex Adult Health |
|---|---|
| Week | 3 |
| Paper type | Concept map with written companion |
| Length | About 1,100 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 341 Week 3
Concept Map: An 81-Year-Old Woman Found on the Floor After a Long Lie, With Treatments Drawn as Boxes and Every Arrow Labeled
Student Name
College of Nursing, Chamberlain University
NR 341: Complex Adult Health
Instructor Name
Month Day, Year
Concept Map: An 81-Year-Old Woman Found on the Floor After a Long Lie, With Treatments Drawn as Boxes and Every Arrow Labeled
The Patient and the Center of the Map
Mrs. W. is 81 and lives alone. Her neighbor found her on her kitchen floor on Tuesday morning; she had fallen on Sunday evening and could not get up. Her heart pumps normally but fills stiffly, a preserved-ejection-fraction heart failure, and she takes furosemide and lisinopril. On admission to the step-down unit at 1100 her creatine kinase is 38,500 units per liter, her creatinine 2.4 mg/dL against 0.9 last spring, her potassium 6.1 mmol/L with peaked T waves on the monitor, and her urine is dark brown, 25 mL in the first hour. She has a 4 by 5 centimeter area of purple, intact skin over her left hip where she lay. Details are composite.
Four failing systems sit in the center of the map, each with the findings that put it there in figures: muscle (creatine kinase 38,500; tender, swollen left thigh), kidneys (creatinine up from 0.9 to 2.4; urine 25 mL an hour, dark brown), heart rhythm (potassium 6.1; peaked T waves), and skin (deep tissue injury over the left hip). Bosch et al. (2009) describe how injured muscle releases myoglobin and potassium into the blood, and how myoglobin damages the kidneys when urine flow is low and the urine acidic, which is the chain linking three of the four boxes.
The center boxes are linked to each other before any treatment is drawn, and those links carry labels too. From muscle to kidneys: "myoglobin released from damaged muscle, filtered and trapped in the tubules." From muscle to heart rhythm: "potassium spilled from broken muscle cells." From kidneys to heart rhythm: "kidneys that cannot clear potassium let it keep rising." That last arrow is the reason the potassium box is expected to get worse before it gets better, even after the first treatment, and it is why the repeat potassium sits in the companion text rather than being left to the morning labs. The skin box has only one arrow into it, from the long lie itself, and none out; it is on the map because it will change what the nurse does every two hours.
The Treatments, Drawn as Boxes
Around the center sit five treatments, each drawn as its own box with arrows running out of it. Table 1 lists every arrow with its sign and its label.
Table 1
Treatment Boxes and Their Labeled Arrows
| Treatment box | Arrow to | Effect | Label on the arrow |
|---|---|---|---|
| Isotonic IV fluid, 200 mL an hour | Kidneys | Helps | Raises urine flow, flushes myoglobin out before it damages tubules |
| Isotonic IV fluid, 200 mL an hour | Lungs and heart | Costs | Heart that fills poorly may back up into the lungs: crackles, falling saturation |
| Calcium gluconate IV | Heart rhythm | Helps | Steadies the heart muscle membrane within minutes; does not lower potassium |
| Insulin with dextrose IV | Heart rhythm | Helps | Moves potassium into cells for a few hours |
| Insulin with dextrose IV | Blood glucose | Costs | Low glucose, most often 1 to 2 hours after the dose, more likely with weak kidneys |
| Holding furosemide and lisinopril | Kidneys | Helps | Removes two drugs that lower kidney blood flow or volume |
| Holding furosemide and lisinopril | Lungs and heart | Costs | Her usual defense against fluid building up is paused while fluid is given |
| Turning every 2 hours, pressure-redistributing mattress | Skin | Helps | Takes weight off the injured hip |
| Turning every 2 hours | Muscle and pain | Costs | Moving a tender thigh hurts; pain may limit turning |
Note. On the drawn map, helping arrows carry a plus and costing arrows a minus.
Both Directions, Drawn Separately
The central tension of this map is the fluid. Its plus arrow to the kidneys and its minus arrow to the lungs start from the same box and are drawn as two separate arrows, not one line with a question mark. For most patients with rhabdomyolysis, generous fluid is the main treatment for protecting the kidneys. For Mrs. W., at 81 with a stiff heart, the same fluid can cause pulmonary edema. The map makes that exchange visible, and the written companion below turns it into a stopping condition.
The insulin box shows the same kind of exchange. Crnobrnja et al. (2020) found that 21% of adults treated with insulin and dextrose for a high potassium developed a low glucose, most often between 60 and 150 minutes after treatment, and that reduced kidney function made it more likely. Mrs. W. has reduced kidney function today. The minus arrow from insulin to glucose is therefore labeled with a time window, which becomes a glucose check at one hour and again at two.
The Written Companion
The map is paired with a short text that says what the nurse watches and when, following the arrows.
Fluid. Urine output hourly, aiming for the target the provider sets, often 200 to 300 mL an hour in rhabdomyolysis, while listening to her lungs and checking her saturation every hour. The stopping condition: new crackles at both bases, a saturation below 92% on her current oxygen, or a breathing rate above 24. Any of these, the fluid is slowed to a keep-open rate and the provider is called, because the minus arrow is now the larger one.
Potassium. Continuous monitoring; repeat potassium at two hours. Peaked T waves that widen, or any new rhythm, mean a rapid response call.
Glucose. Fingerstick at 1 and 2 hours after insulin, then hourly until stable.
Kidneys. Creatinine and creatine kinase every 12 hours; urine color noted each hour, since clearing from brown to yellow is one of the first signs that the fluid is working.
Skin. The hip is photographed and measured once a day, the mattress is checked each shift, and pain is treated 30 minutes before turning so that the minus arrow from turning does not stop the plus arrow from happening.
What the Map Leaves Out
The map does not include her fall itself, the cause of her fall, or her ability to go home, all of which will matter this week. It is limited to the next 24 to 48 hours, when the four center boxes and the five treatments can change quickly. A second map, for the discharge planning later in the week, would have a different center.
References
Bosch, X., Poch, E., & Grau, J. M. (2009). Rhabdomyolysis and acute kidney injury. New England Journal of Medicine, 361(1), 62-72. https://doi.org/10.1056/NEJMra0801327
Crnobrnja, L., Metlapalli, M., Jiang, C., Govinna, M., & Lim, A. K. H. (2020). The association of insulin-dextrose treatment with hypoglycemia in patients with hyperkalemia. Scientific Reports, 10, Article 22044. https://doi.org/10.1038/s41598-020-79180-7
What the NR 341 Week 3 assignment asks for
The Week 3 concept map asks you to connect a complex patient's problems, the relationships between them and the treatments that affect them. You will likely need central problems supported by data, labeled links between them, interventions shown on the map, the effects of each intervention, a narrative explanation and references. Keep the center to the few systems that are failing, each with the figures that put it there. Label every arrow with what travels along it. Draw treatments as boxes so their effects can be traced. Show the help and the cost of one treatment as two separate arrows. Add a written companion that turns each arrow into a check with a time. Say what the map deliberately excludes.
How the NR 341 Week 3 example is put together
The first section describes Mrs. W., who fell on Sunday evening and was found on Tuesday, along with her heart failure with preserved ejection fraction. The center lists muscle, kidneys, potassium and skin, each with values, and the links between them carry labels such as myoglobin trapped in the tubules. Table 1 lists every treatment arrow with its sign and label. The next section explains why fluid has two arrows, one helping the kidneys and one costing the lungs, with Bosch and colleagues on rhabdomyolysis. Insulin with dextrose gets the same treatment using the 21% hypoglycemia figure. The companion gives hourly urine, potassium at two hours, glucose checks, labs every 12 hours and skin care. The last section names the omissions.
Where the points sit in the NR 341 Week 3 rubric
Concept map rubrics in this course typically score identification of priority problems with supporting data, accuracy of relationships, inclusion of interventions and their effects, the explanatory narrative, use of evidence and APA. Relationships carry heavy weight, and they earn credit when every arrow has a label a reader can check. Supporting data is credited because each central system shows its numbers. The intervention row scores best when treatments appear as boxes with plus and minus arrows, which this map does. Showing the fluid's cost to the lungs as its own arrow is the kind of complex reasoning graders reward. The companion text earns points by turning arrows into monitoring with times. Bosch and colleagues and Crnobrnja and colleagues support the evidence row.
Common NR 341 Week 3 mistakes, and how to avoid them
The map that costs the most has no treatment on it, so it can only show a body getting sicker. Next is a map with arrows that carry no labels, leaving the grader to guess what each line means. Students also crowd the center with every diagnosis on the chart, or draw a single line with a question mark where a treatment both helps and harms. A narrative that repeats the map in sentences instead of saying what the nurse watches earns little. Leaving out stopping conditions for fluid is a common clinical gap in older patients with heart failure. Software is optional; clarity is not. If your assigned patient has a different condition, send the case and an NR 341 concept map can be laid out with labeled arrows for it.
Get a NR 341 Week 3 example written to your instructions
Send the Week 3 prompt, the mapping template your classroom supplies and the case you are working from, and a custom example comes back inside 24 to 48 hours, free the first time. You get the drawing and the written companion together, since the credit in this week is usually split across both halves.
More NR 341 papers and pre-licensure samples
- NR 341 Week 1: Competing Priorities Discussion Post
- NR 341 Week 2: Priority-Setting Case Analysis
- NR 341 Week 4: Shock Case Response
- NR 341 Week 5: Ventilated Patient Write-up
- NR 341 Week 6: Delegation Scenario Response
- NR 341 Week 7: Rapid Response Analysis
- NR 341 Week 8: Complex Care Plan
- NR 452 Week 3: Literature Matrix
- NR 328 Week 3: Well-Child Visit Write-Up
- NR 103 Week 3: RN Role and Delegation Paper
- NR 327 Week 3: Fetal Movement Teaching Plan
NR 341 Week 3 questions, answered
Does the map need software?
Whatever your classroom accepts. Hand drawn maps photographed cleanly are marked on the same terms as software ones, and the format itself almost never carries points. Legibility does. A page that has to be enlarged before an arrow label can be read loses credit no amount of tidy styling wins back, so check the size the finished thing will be viewed at.
How many boxes is too many?
The practical test is whether you can trace a path from one edge of the page to the other without losing your place. Some sections give a range, and where yours does not, three or four systems with their treatments is usually the ceiling. A drawing that has to shrink its labels to fit has already passed the point where it can be marked properly.
Should the map show what was chosen, or every possibility?
Both, but not at equal weight. Draw the relationships that exist, then mark the path the plan actually follows so a reader can see the decision inside the network. A page showing every possible connection at identical visual weight has handed the ranking back to the marker, and the ranking is the part under assessment.
Where can I find a free NR 341 Week 3 sample paper?
The full Week 3 concept map narrative for Mrs. W., with the four central systems, the arrow table, the two-way fluid arrows, the written companion and the references, appears on this page.
How does the NR 341 Week 3 map show that fluid both helps and harms?
The fluid box sends two separate arrows, a plus to the kidneys for flushing myoglobin and a minus to the lungs because her stiff heart can let fluid back up, each with its own label.