| Course | NR 570 Common Diagnosis and Management in Acute Care Practicum |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 560 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Acute Care NP (AGACNP) |
| Updated | October 2026 |
Free sample paper for NR 570 Week 1
Week 1 Discussion: Initial Post
The Line Nobody Reads Twice: Why the Sentence on What a Patient Managed Before Admission Belongs First in a Routine Acute Care Note
Initial Post
Most of us will admit a patient this term with a condition everyone on the unit has seen a hundred times. My position is that, in exactly those routine admissions, the line of the history that should be written first and most carefully is the one describing what the person could manage two weeks before this illness began. On our service it usually sits under social history as "independent" or "lives alone," if it appears at all.
I want to name the line precisely. I mean a sentence like this one, from a note I wrote last week for a 74-year-old admitted with a small bowel obstruction: "Lives alone on the second floor, walks about a mile most mornings, drives, fills a weekly pillbox without help." That sentence took two minutes to collect from the patient and a neighbor. It is the only line in the note that tells the next clinician what recovery should look like.
My reason is checkable. Covinsky et al. (2003) followed older adults admitted to general medical services and found that 35% were less able to perform basic daily activities at discharge than they had been two weeks before admission, and the proportion rose steeply with age. Some of that loss happened before admission and was never recovered; some happened in the hospital itself. Neither kind can be measured without a baseline written down at the start. Boyd et al. (2008) then followed the people who left the hospital with a new disability: a year later, fewer than a third had returned to their earlier level.
Routine cases are where this matters most, because the condition does not draw attention to function. Nobody forgets to ask about breathing in heart failure. Plenty of us forget to ask whether a person with an obstructed bowel walked a mile a day, and then discharge them after four days in bed with an NG tube without noticing they now need a hand on the rail.
So my claim is narrow. The baseline sentence should be written before the review of systems, it should name activities rather than a label like "independent," and it should be repeated in the discharge summary so the gap, if any, is visible.
Reply to Alyssa
Alyssa, you argued that the medication reconciliation should come first in a routine admission, and your example of the duplicate beta blocker was convincing. I wonder whether the two lines support each other. The pillbox detail in my sentence above told me who manages the medicines at home, which changed how I trusted the list. Would your reconciliation change if the note said a daughter fills the pillbox every Sunday? If so, maybe the baseline line is where your reconciliation starts.
Reply to Brandon
Brandon, your post said function is "covered by the PT consult." I would push on that. In my patient's case the physical therapy referral was placed on day 3, and the therapist's first question was what the patient could do before admission. Nobody had written it down, so the therapist asked the patient again. The consult relies on the baseline line; it does not replace it. What would your note have recorded on day 1?
References
Boyd, C. M., Landefeld, C. S., Counsell, S. R., Palmer, R. M., Fortinsky, R. H., Kresevic, D., Burant, C., & Covinsky, K. E. (2008). Recovery of activities of daily living in older adults after hospitalization for acute medical illness. Journal of the American Geriatrics Society, 56(12), 2171-2179. https://doi.org/10.1111/j.1532-5415.2008.02023.x
Covinsky, K. E., Palmer, R. M., Fortinsky, R. H., Counsell, S. R., Stewart, A. L., Kresevic, D., Burant, C. J., & Landefeld, C. S. (2003). Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: Increased vulnerability with age. Journal of the American Geriatrics Society, 51(4), 451-458. https://doi.org/10.1046/j.1532-5415.2003.51152.x
Reading the NR 570 Week 1 instructions
This first discussion asks you to take a position on what matters most when a case looks routine, and to tie that position to a specific part of the patient record. Expect a short post, around two or three hundred words, plus replies. Name the part exactly, such as the line on baseline function, the sentence explaining a treatment choice or the note of who was told what. Then say why it deserves priority in a common case, give one reason a marker can check, and cite a published source rather than personal habit. Keep the post balanced in length, without a long block of background. Two replies are typical, each engaging the classmate's argument rather than repeating it.
How this NR 570 Week 1 example is built
The sample opens by naming the line it will defend: the baseline function sentence that often appears only as the word independent. It quotes an actual version from an obstruction admission, listing walking, driving and the pillbox. A paragraph then gives the checkable reason, with figures from two studies on loss of daily function during and after hospital stays. Another paragraph explains why routine cases make the problem worse, and the post closes with a three-part claim about where the line belongs. The first reply suggests that a classmate's chosen line depends on this one. The second answers the view that therapy consults cover function by describing what the therapist actually asked.
Where the points sit in the NR 570 Week 1 rubric
In this discussion the marks follow the specificity of the claim. A post that agrees with the obvious and stops there earns little, because anyone could write it about any condition. The next criterion is an instance: a quoted line from a real or composite note, not a general complaint about thin records, and this sample quotes one. Evidence counts separately, so a published cohort study scores where personal practice does not. Even length across the post shows planning. Replies are marked on engagement with the classmate's argument, and posts made after the board closes lose those points. Questions that ask a peer to test their claim against a specific event score well.
NR 570 Week 1 help from the desk
Students in NR 570 Week 1 most often write a summary of the reading with no position at all. Another common problem is a claim with nothing underneath it, such as a statement that notes are too short without one example line. Posts that rest on what the writer does at work, without any source, read as opinion. Some posts spend most of their length on background and squeeze the argument into the last sentences. Replies that praise and restate earn little. If your section asks about a different part of the record, send its prompt with your choice; a post for that part can be drafted with a quoted line and a checkable source.
Get a NR 570 Week 1 example written to your instructions
Send the discussion instructions, the posting requirements your classroom lists and the condition your section is working on, and a custom post written to that word count comes back inside 24-48h. The first one is free, revisions included, and it arrives as a model to argue your own position against.
More NR 570 papers and AGACNP samples
- NR 570 Week 2: Frequent Presentation Case Paper
- NR 570 Week 3: Guideline Concordance Write-up
- NR 570 Week 4: Admission Note Critique
- NR 570 Week 5: Progress Note Sequence
- NR 570 Week 6: Discharge Summary Draft
- NR 570 Week 7: Supervised Encounter Write-up
- NR 570 Week 8: Common Case Portfolio Piece
- NR 569 Week 1: Fever and Back Pain Discussion Post
- NR 567 Week 1: Status Epilepticus Route Discussion
NR 570 Week 1 questions, answered
How long is a Week 1 post supposed to run?
Whatever your classroom states, and it is usually modest: two to three hundred words in many sections. Length is not what moves this grade. A short post carrying one claim, one instance and one source scores above a long one that summarizes the week's reading, because the rubric rows ask for a position with evidence beneath it rather than for breadth.
Do I need a case from my rotation this early?
Usually not. Opening discussions tend to ask for an argument about documentation rather than for an encounter you attended, and a constructed illustration answers that. If your section does want something you saw, keep it at the level of presentation and setting, leave out anything that could identify a person or a place, and let the argument carry the post.
Can I disagree with the assigned reading?
Yes, and sections that reward argument tend to reward it well, provided the disagreement is specific. Name the sentence you are contesting, say what your own reading of a record shows instead, and bring a second published source rather than experience alone. A post dismissing the reading without engaging a particular line reads as unprepared.
Where can I find a free NR 570 Week 1 sample paper?
The full post arguing for the baseline function line, with replies to Alyssa and Brandon, appears on this page with margin notes on why each part scores.
Which part of the record does the NR 570 Week 1 post defend?
The sentence describing what the patient could do two weeks before admission, such as walking, driving and managing medicines, because hospital-related decline can only be measured against it.