NR 576 Week 2 Problem List Review Example

Course	NR 576 Differential Diagnosis in Adult-Gerontology Primary Care
Week	2
Paper type	Problem list review
Length	About 1,110 words, 5 pages
Format	APA 7 student paper
School	Chamberlain University
Program	MSN, Adult-Gerontology Primary Care NP (AGPCNP)
Updated	October 2026

Free sample paper for NR 576 Week 2

Problem List Review for a 78-Year-Old With Diabetes: When Each Entry First Appeared, Who Put It There, What It Rested On and Which Ones No Longer Hold

Student Name

College of Nursing, Chamberlain University

NR 576: Differential Diagnosis in Adult-Gerontology Primary Care

Instructor Name

Month Day, Year

What this page is doingThe review attaches a date, an author and a basis to each entry on the record, and the findings fall out of that: a symptom carried as a diagnosis, a duplicate and a provisional label never confirmed.

Problem List Review for a 78-Year-Old With Diabetes: When Each Entry First Appeared, Who Put It There, What It Rested On and Which Ones No Longer Hold

Why This Review and How It Was Done

This patient is a composite, built from cases in my primary care placement: 78 years old, type 2 diabetes for 18 years, now presenting with falls and numbness spreading to the knees and fingertips. Before reasoning about the new complaint, I reviewed the problem list, because the record will be read as an explanation for everything new. I traced each entry back through the electronic record and the scanned hospital records to the note where it first appeared, and recorded who added it and what it rested on at the time. The list had nine entries.

The Entries Traced

Table 1

Problem List Entries Traced to Their First Appearance, Author and Basis

Entry as listed	First appears	Added by	What it rested on
Type 2 diabetes	2007	Previous primary care physician	A1c 7.9% and fasting glucose of 162 on two occasions
Hypertension	2009	Previous primary care physician	Three office readings above 150/90
Diabetic peripheral neuropathy	2019	Current practice, nurse practitioner	Reduced monofilament sensation at both great toes; no other testing
Dizziness	2021	Urgent care clinic, imported	Patient report of feeling dizzy on standing; no vital signs recorded standing
Benign prostatic hyperplasia	2016	Urology	Symptom score and examination
Gastroesophageal reflux disease	2015	Previous primary care physician	Heartburn; omeprazole started; no endoscopy
Anemia of chronic disease	2022	Hospital discharge summary, imported	Hemoglobin 11.4 during an admission for cellulitis; listed as "likely anemia of chronic disease"
Memory complaints	2023	Current practice	Daughter's concern; Mini-Cog 3 of 5
Neuropathy	2021	Podiatry, imported	Podiatry note

What this page is doingAttaching a date, an author and a basis to each line is what allows the findings to emerge from the record rather than from suspicion.

How Each Entry Was Traced

For each line I searched the record for the earliest note that used the term, then opened that note to see who wrote it and on what. For imported entries, from urgent care, the hospital and podiatry, I opened the outside document scanned into the chart. Where an entry had been carried forward by copying, I followed it back past the copies to the first author. Two entries took the longest: the anemia, which appeared first in a hospital summary and then in eleven later notes without any new information, and the dizziness, which had been copied into every annual visit since 2021 with the same wording. I recorded only what the first note said, not what later notes assumed, because later notes mostly repeated it word for word.

What the Patient and Daughter Added

I asked the patient and daughter about three entries. Neither remembered being told about anemia. The patient said the dizziness from 2021 was the same feeling as now, on standing in the morning, and that it had never been checked by standing measurements. The daughter said the podiatrist's neuropathy and the doctor's neuropathy were, as far as the family knew, the same thing. Their accounts did not settle anything, but they confirmed that two entries had never been revisited with the patient.

What this page is doingAsking the patient and family about the entries adds a second source and shows which labels were never explained to the person they describe.

What the Tracing Shows

Four findings fall out of the table, and they are ranked by how much they matter to the new complaint.

First, "anemia of chronic disease" was provisional when written. A discharge summary called it likely, during an infection, with no iron studies, B12 or folate measured. It has been carried for three years without anyone confirming it. A hemoglobin of 11.4 in an older adult on long-term metformin and a proton pump inhibitor is not confirmed as anemia of chronic disease until the alternatives have been looked at. What would confirm it: a mean corpuscular volume, iron studies, B12 and folate, and a normal result for the last two.

Second, "dizziness" is a symptom wearing a diagnosis's name. It entered from an urgent care visit, where no standing blood pressure was recorded. Four years later, the patient is falling. What would replace it with a diagnosis: blood pressure lying and after one and three minutes standing. Orthostatic hypotension means a fall of at least 20 in systolic or 10 in diastolic pressure, sustained within three minutes of standing (Freeman et al., 2011), and the patient takes tamsulosin and hydrochlorothiazide, both of which can lower standing pressure.

Third, "diabetic peripheral neuropathy" rests on a single monofilament examination. That test detects loss of protective sensation; it does not establish the cause of a neuropathy or test position sense. The label may be correct, but it has never been examined against other causes, and B12 deficiency, which metformin can cause, was never measured (Aroda et al., 2016).

Fourth, "neuropathy" from podiatry duplicates the third entry under a different name.

Why the Findings Are Ranked This Way

The anemia comes first because it is the only entry that, if wrong, hides a treatable cause of both the blood finding and the new neurologic complaint. The dizziness comes second because it is the most likely contributor to the falls and can be tested in five minutes at the next visit. The neuropathy label comes third: it is probably partly right, and the question is what else is present. The duplicate comes last because it changes nothing clinically, although it inflates the record and makes the neuropathy look better documented than it is.

Entries That Hold

Type 2 diabetes, hypertension and benign prostatic hyperplasia rest on adequate bases and are not in question. Reflux rests on symptoms and a response to treatment, which is reasonable, but the treatment itself, nine years of daily omeprazole, has become relevant: Lam et al. (2013) linked two or more years of acid-suppressing drugs to a higher chance of a new B12 deficiency diagnosis. Memory complaints rest on a screening test and are correctly labeled as complaints, not as a diagnosis.

Recommendations to the Record

Merge the two neuropathy entries and mark the merged entry as "peripheral neuropathy, cause under review." Change "dizziness" to "dizziness on standing, orthostatic vital signs pending." Change "anemia of chronic disease" to "anemia, cause not established." No entry is removed; each is relabeled to show its current status.

What this page is doingRecommending relabeling rather than deletion keeps the record's history visible while showing what is and is not established.

What This Review Does Not Do

It does not diagnose the new complaint. It sets out what the record can and cannot be relied on to explain, so the reasoning in the next weeks starts from an accurate list rather than an inherited one.

References

Aroda, V. R., Edelstein, S. L., Goldberg, R. B., Knowler, W. C., Marcovina, S. M., Orchard, T. J., Bray, G. A., Schade, D. S., Temprosa, M. G., White, N. H., & Crandall, J. P. (2016). Long-term metformin use and vitamin B12 deficiency in the Diabetes Prevention Program Outcomes Study. Journal of Clinical Endocrinology & Metabolism, 101(4), 1754-1761. https://doi.org/10.1210/jc.2015-3754

Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., Goldstein, D. S., Hainsworth, R., Hilz, M. J., Jacob, G., Kaufmann, H., Jordan, J., Lipsitz, L. A., Levine, B. D., Low, P. A., . . . van Dijk, J. G. (2011). Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clinical Autonomic Research, 21(2), 69-72. https://doi.org/10.1007/s10286-011-0119-5

Lam, J. R., Schneider, J. L., Zhao, W., & Corley, D. A. (2013). Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA, 310(22), 2435-2442. https://doi.org/10.1001/jama.2013.280490

NR 576 Week 2 instructions, in plain terms

The Week 2 review asks you to examine the problem list of a patient with a long record. Expect a worked document with prose around it rather than an essay. Each condition should appear with three things attached: when it first shows up, who put it there and what it rested on at the time. The findings usually fall out of that alone: a symptom carried as a disease, a condition listed twice under two names, or a provisional impression from a discharge summary never confirmed. Most prompts want the findings ranked rather than every line questioned equally, and want each unconfirmed entry to say what would confirm it. Recommendations to the record usually close the review.

How this NR 576 Week 2 example is built

The review explains why it was done and how many entries the list held. A table traces all nine entries to a year, an author and a basis. A section describes how each was traced, past copied notes to the first author and into scanned outside documents. Another records what the patient and daughter remembered about three entries. Four findings are ranked: an anemia label written during an infection and never tested, dizziness carried for four years without standing pressures, a neuropathy label resting on one monofilament test, and a duplicate. A ranking section explains the order. Entries that hold are listed, and relabeling recommendations close the review.

Reading the NR 576 Week 2 grading rubric

The worst outcome is a review that reproduces the list with commentary and changes nothing, since nothing has been audited. Questioning every line equally is the next costly habit, since it reads as suspicion and gives no ranking; this sample ranks four findings and explains why. A symptom left standing as a diagnosis without comment loses a row, and the dizziness entry is addressed. Each unconfirmed entry here says what would confirm it. Dates and authors traced from the record satisfy the documentation criterion. Recommending relabeling, rather than deletion, shows judgment about how records should change. Tracing imported entries back to the outside document, not the first copy, shows the audit went to the source.

Common NR 576 Week 2 mistakes, and how to avoid them

Weak NR 576 Week 2 reviews copy the problem list and add a sentence to each line. Others challenge every entry, which hides the ones that matter. Many skip the dates and authors that the record supplies. Symptoms listed as diagnoses are often left unremarked. Some reviews recommend deleting entries outright, which loses history. Few say what would confirm a provisional label. If your patient's record differs, send the problem list with any history you have; a review can trace each entry and rank the findings. Trace each line to its first author before judging it. Rank the findings by how much each could hide, and say what result would confirm each provisional label.

Get a NR 576 Week 2 example written to your instructions

Send the record or scenario your section published, along with the rubric and any table your classroom wants the review laid out in. A custom NR 576 Week 2 problem list review is written to those requirements and comes back inside 24-48h, with nothing to pay on a first request, formatted so it can sit beside your own draft.

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NR 576 Week 2 questions, answered

Should the review recommend removing entries from the record?

It should say which lines do not belong and why, and stop short of describing the mechanics of altering a chart. The example marks a line as unsupported, states what would confirm it, and notes who would need to be involved. Most classrooms grade the judgment and the reasoning behind it rather than any administrative step that would follow.

What if the material does not say when a diagnosis was made?

Then the absence is itself a finding and the example writes it that way. It records that the line appears with no date and no originating document, notes the earliest point at which it can be shown to exist, and treats that as the limit of what can be claimed. Guessing a date to fill the column costs more than leaving it visibly empty.

Does every condition need the same amount of attention?

No, and even coverage is a common way these papers thin out. The example gives most of its length to the lines shaping current treatment or capable of changing how a new symptom is read, and handles the settled ones in a sentence each. Proportion is usually what separates a review that made judgments from one that filled a template.

Where can I find a free NR 576 Week 2 sample paper?

This page shows the full problem list review with nine traced entries and four ranked findings for the 78-year-old with diabetes.

Which entry does the NR 576 Week 2 review rank first?

Anemia of chronic disease, because it was a provisional label from a hospital stay during infection, never tested, and could hide a treatable cause of the new complaint.