| Course | NR 574 Acute Care Practicum I |
|---|---|
| Week | 7 |
| Paper type | Rounds presentation outline |
| Length | About 490 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Acute Care NP (AGACNP) |
| Updated | October 2026 |
Free sample paper for NR 574 Week 7
Rounds Presentation Outline: Day 3 of Bilevel Ventilation for a 71-Year-Old With a COPD Exacerbation, Asking the Team to Approve a Two-Hour Trial Off the Machine
Student Name
College of Nursing, Chamberlain University
NR 574: Acute Care Practicum I
Instructor Name
Month Day, Year
Rounds Presentation Outline: Day 3 of Bilevel Ventilation for a 71-Year-Old With a COPD Exacerbation, Asking the Team to Approve a Two-Hour Trial Off the Machine
Opening Line
71, COPD exacerbation, day 3 of bilevel ventilation; here because I want to start trials off the machine today.
Overnight
On bilevel 12 hours overnight. No events. Slept. Off for meals without distress.
[If late, cut: night nursing note detail; sputum color.]
What Changed
Gas this morning: pH 7.38, CO2 60, bicarbonate 35.
Admission gas: pH 7.26, CO2 74.
Respiratory rate 20 off the machine for breakfast, 45 minutes.
Saturation 90 to 92% on 2 L, target 88 to 92%.
[If late, cut: day 2 gas; white count.]
Exam, Only What Matters
Talks in complete sentences. Neck muscles quiet at rest. Wheeze reduced.
Medicines Relevant to the Ask
Prednisone day 3 of 5. Nebulizers every 4 hours. Doxycycline day 3.
[If late, cut: home inhalers.]
Assessment
Hypercapnic exacerbation improving; acidemia resolved; CO2 trending to known baseline (bicarbonate in the mid-30s on prior admissions); pH read with compensation, not CO2 alone (Berend et al., 2014).
Plan
Two-hour trial off bilevel at 10:00, on nasal cannula at 2 L.
Repeat venous gas at 11:00.
Back on if: pH below 7.35, respiratory rate above 28 or patient asks.
Continue overnight bilevel tonight.
Physical therapy to see today.
Questions I Expect, Answers in Reserve
Respiratory therapist: "Why not overnight off too?" Because overnight hypoventilation is the risk in this patient; one step at a time.
Hospitalist: "Home bilevel?" Not yet; reassess before discharge with the overnight data, and discuss with pulmonary.
Pharmacist: "Steroids longer?" No; five days total is the plan.
The Ask
Does the team agree to a two-hour trial off bilevel ventilation at 10:00 this morning, with a venous gas at 11:00 and the stop criteria above?
Numbers Held Back Unless Asked
White count 9.1, down from 12.4. Weight unchanged. Potassium 4.2 on the steroid. Glucose up to 214 on the steroid, covered by correction insulin. Last admission's CO2 58, for comparison.
Why the Outline Looks Like This
It is fragments, not sentences, because I will not read it aloud. The order follows what the team needs to decide, not the order of the chart. Respondents to a survey of internal medicine clerkship directors rated a prioritized assessment and plan as one of the most important parts of an oral presentation and expected a new-patient presentation to take about seven minutes (Green et al., 2009); a follow-up patient on rounds gets less. The stop criteria follow the noninvasive ventilation guideline's focus on acidemia and work of breathing (Rochwerg et al., 2017).
References
Berend, K., de Vries, A. P. J., & Gans, R. O. B. (2014). Physiological approach to assessment of acid-base disturbances. New England Journal of Medicine, 371(15), 1434-1445. https://doi.org/10.1056/NEJMra1003327
Green, E. H., Durning, S. J., DeCherrie, L., Fagan, M. J., Sharpe, B., & Hershman, W. (2009). Expectations for oral case presentations for clinical clerks: Opinions of internal medicine clerkship directors. Journal of General Internal Medicine, 24(3), 370-373. https://doi.org/10.1007/s11606-008-0900-x
Rochwerg, B., Brochard, L., Elliott, M. W., Hess, D., Hill, N. S., Nava, S., Navalesi, P., Antonelli, M., Brozek, J., Conti, G., Ferrer, M., Guntupalli, K., Jaber, S., Keenan, S., Mancebo, J., Mehta, S., & Raoof, S. (2017). Official ERS/ATS clinical practice guidelines: Noninvasive ventilation for acute respiratory failure. European Respiratory Journal, 50(2), Article 1602426. https://doi.org/10.1183/13993003.02426-2016
NR 574 Week 7 instructions, in plain terms
The Week 7 assignment asks for the outline you would present from on rounds, usually one side of paper. Set it out as headed fragments rather than sentences, because none of it is meant to be read aloud. The opening line fixes who the patient is and why the team is hearing about them. The pieces follow in listening order, each trimmed to the words that change what the team does. Mark what goes when the round runs late, often with brackets or a second margin, and list the two or three questions you expect with the answers held in reserve. End on the ask, written out in full, so the team knows what is wanted.
How the NR 574 Week 7 example is put together
The outline opens with a single line: age, condition, day of ventilation and the reason for presenting today. Overnight events, the morning gas beside the admission gas, the trial of breakfast off the machine and the oxygen target follow as fragments. Bracketed cuts appear under three sections. The examination is three short lines. Medicines relevant to the ask are listed. The assessment reads the pH with compensation. The plan gives the trial time, the gas, stop criteria in numbers and tonight's plan. Three expected questions have answers in reserve, spare numbers are held back, the ask is written out and a short section explains the format with a survey on presentations.
Where the points sit in the NR 574 Week 7 rubric
The full script is the expensive mistake, because an outline in sentences cannot be cut mid round; this one is fragments throughout. An outline with no ask loses nearly as much, leaving the room with a report and no question. Chart order, opening on history and reaching the change four minutes in, costs the organization row; the opening line here states why the patient is being presented. Holding nothing in reserve risks one routine question derailing the plan, so three answers sit ready. Marked cuts for a late round earn credit few drafts collect. Stop criteria in numbers make the plan approvable. Brevity is graded too.
NR 574 Week 7 help: mistakes that cost points
Many NR 574 Week 7 outlines are full scripts that cannot be shortened when the round runs late. Others end without an ask. Writers often follow the order of the chart, starting with the history of present illness. Few mark what to cut, and fewer prepare answers to expected questions. Plans without stop criteria invite the team to ask what would end the trial. If your patient differs, send the overnight events and the decision you need from the team; an outline can be built on one side with the ask at the end. Practice once aloud with a timer, and cut until the essentials take under three minutes.
Get a NR 574 Week 7 example written to your instructions
The assignment file, the rubric and a few facts about the case you plan to present are enough to start from. A custom NR 574 Week 7 outline is returned inside 24-48h, the first one free, in fragments, with the cuts, the reserve answers and the ask laid out. Tell us the format your own service uses and it gets built to that.
More NR 574 papers and AGACNP samples
- NR 574 Week 1: First Practicum Week Discussion Post
- NR 574 Week 2: Practicum Learning Objectives
- NR 574 Week 3: Practicum Orientation Write-Up
- NR 574 Week 4: Weekly Practicum Journal
- NR 574 Week 5: Midpoint Self-Appraisal
- NR 574 Week 6: Exposure Gap Memo
- NR 574 Week 8: End of Rotation Summary
- NR 573 Week 7: Case Simulation Analysis
- NR 567 Week 7: ICU Anticoagulation Case Analysis
- NR 572 Week 7: ICU Handoff Summary
- NR 569 Week 7: Revised Differential Note
NR 574 Week 7 questions, answered
Is the outline handed in, or the presentation?
The outline, in most sections, sometimes with a recording or a live delivery attached. That is worth settling before drafting, because a document meant to be read by a grader and a document meant to be held in a hand look different. The graded version usually carries a short note explaining the cuts, which a working copy would not.
Why does a full workup score badly here?
A write-up is complete and a presentation is selective, and the selection is the skill being assessed. Everything earning marks in a full workup, exhaustive history, every normal finding, loses them here. The outline shows what the writer decided the team did not need, which a written case never has to reveal.
The team's format is different from the one taught.
Then the team's format is the one to build on, and saying so in the submission usually earns credit rather than costing it. Services differ on where they want the plan and whether they take questions throughout. An outline matching the room it will be used in, with a line explaining the local convention, marks better than a textbook sequence.
Where can I find a free NR 574 Week 7 sample paper?
The full one-side rounds outline for the patient on bilevel ventilation, with bracketed cuts and reserved answers, is on this page.
What is the ask in the NR 574 Week 7 rounds outline?
Whether the team agrees to a two-hour trial off bilevel ventilation at 10:00, with a venous gas at 11:00 and stop criteria for pH, respiratory rate and patient request.