NRNP 6540 Week 3 Post-Fall Evaluation Note Example

Course	NRNP 6540 Advanced Practice Care of Older Adults
Week	Week 3
Paper type	Post-fall evaluation note
Length	About 760 words, 5 pages
Format	APA 7 student paper
School	Walden University
Program	Master of Science in Nursing (MSN)
Updated	October 2026

Free sample paper for NRNP 6540 Week 3

Post-Fall Evaluation Note: A Nighttime Fall After Standing From Bed in a 79-Year-Old Woman

Student Name

College of Nursing, Walden University

NRNP 6540: Advanced Nurse Practice in Primary Care Adult Gerontology II

Instructor Name

Month Day, Year

What this page is doingThe title records the circumstance of the fall, standing from bed at night, because that circumstance points the evaluation toward orthostatic causes before any test is done. A post-fall note is graded on whether the account of the fall is used, and the title shows it was.

Post-Fall Evaluation Note: A Nighttime Fall After Standing From Bed in a 79-Year-Old Woman

The Fall, in Her Sequence

M.T., a 79-year-old retired dental hygienist who is a composite patient, describes the fall this way: at about 2 a.m. she got up to use the bathroom, stood from the edge of her bed, felt lightheaded "like the room went gray," reached for the dresser, missed it, and went down onto her left hip. She did not lose consciousness. She lay still for a minute, then got herself up using the bed and walked to the bathroom. She has bruising on the left hip but no pain on walking. This is her second fall in six months; the first also happened in the dark, heading for the toilet.

That account, lightheadedness on standing without loss of consciousness, moves the evaluation toward orthostatic causes and away from a mechanical trip or a seizure. She denies palpitations, chest pain, one-sided weakness, confusion afterward, or tongue biting.

She wakes two or three times each night to urinate. Her medications include furosemide 20 mg taken in the evening "so I don't have to run to the bathroom at church," lisinopril, and a drugstore sleep product whose active ingredient is diphenhydramine, begun three months ago because the nighttime trips kept her awake.

Home, as she described it: a loose rug beside the bed, no night light, and a bathroom down a hallway.

Objective

Orthostatic vital signs, method recorded: blood pressure and heart rate measured after five minutes lying supine, then at one and three minutes after standing, with the cuff at heart level. Supine: 138/78, heart rate 72. Standing at one minute: 112/66, heart rate 80. Standing at three minutes: 116/68, heart rate 82. She reported mild lightheadedness at one minute. A fall in systolic pressure of 20 mm Hg or more within three minutes of standing meets the usual definition of orthostatic hypotension, and her drop of 26 mm Hg at one minute does; the small rise in heart rate suggests a volume or medication cause rather than a primary autonomic failure alone.

Gait, from observation: slightly slowed, with a narrow base and good arm swing; she does not use an assistive device. Timed Up and Go: 14 seconds, with a steady turn (Podsiadlo & Richardson, 1991).

Vision: reading glasses only; last eye examination four years ago; distance vision 20/50 in the left eye. Feet: thick nails and a bunion on the right; no numbness to monofilament. Footwear: backless slippers at night. Left hip: bruising over the greater trochanter, full painless range of motion, bears weight normally.

Assessment: Contributors, Ordered by How Modifiable Each Is

1. Evening furosemide causing nocturia and volume shifts: highly modifiable; the dose timing puts her diuresis at night.

2. Diphenhydramine sleep aid: highly modifiable; a sedating anticholinergic on the Beers list of drugs to avoid in older adults, contributing to drowsiness, confusion, and orthostatic lightheadedness at night (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023).

3. Orthostatic hypotension: modifiable through the first two changes, fluid intake, and slow rising.

4. Home hazards: modifiable with a rug removed and a night light added.

5. Footwear and vision: modifiable with closed-back shoes and an eye examination.

6. Age-related gait change and bunion: partly modifiable through strength and balance exercise.

No injury requiring imaging: she bears weight painlessly with full hip motion.

Plan, Following STEADI

The CDC's STEADI approach organizes fall prevention as screen, assess, and intervene (Stevens & Phelan, 2013).

Screen: she has fallen, feels unsteady at night, and worries about falling, so she screens at risk.

Assess: completed above: the fall history, orthostatic measurements, gait and Timed Up and Go, medication review, vision, feet and footwear, and home hazards.

Intervene: move furosemide to the morning; stop diphenhydramine and address sleep with limiting evening fluids and a regular bedtime routine rather than a sedative; teach slow rising, sitting on the side of the mattress and counting to sixty before standing; night light and removal of the bedside rug, with a home safety evaluation by occupational therapy; closed-back shoes or slippers with a firm sole; eye examination; physical therapy for strength and balance. Vitamin D intake was reviewed.

Follow-up: two weeks for repeat orthostatic measurements after the medication changes, and a call from the nurse in three days to ask about nighttime symptoms. Her daughter, who lives nearby, will check in by phone each morning for the next two weeks, and she was shown how to get up from the floor safely and given a personal alarm she agreed to wear at night.

References

2023 American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372

Podsiadlo, D., & Richardson, S. (1991). The timed "Up & Go": A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

Stevens, J. A., & Phelan, E. A. (2013). Development of STEADI: A fall prevention resource for health care providers. Health Promotion Practice, 14(5), 706-714. https://doi.org/10.1177/1524839912463576

What the NRNP 6540 Week 3 instructions ask for

The third week of NRNP 6540 typically asks for an evaluation note after a fall in an older adult. You document the fall in detail, separate syncope from a mechanical fall, examine for injury and risk factors, review medications, identify all contributors and plan prevention using a recognized framework such as STEADI. Faculty expect more than one contributor, since falls in older adults are rarely due to a single cause. Cite STEADI, fall prevention guidelines and the Beers Criteria in APA 7. Orthostatic vital signs are expected in the examination. The plan should respect the person's wish to stay independent. Follow-up and referral, for example to physical therapy, are commonly required.

How the NRNP 6540 Week 3 example is put together

Fall details come first and in the patient's sequence: she stood from bed, felt lightheaded, reached for the dresser, and went down, with no loss of consciousness and no difficulty getting back up. That account moves the note toward orthostatic causes, and the objective section confirms a drop in pressure on standing, recorded with its method. Gait is described from observation and a Timed Up and Go. Vision, feet, and footwear have a line each. The medication review finds an evening diuretic producing nocturia and a sleep aid bought over the counter. Home hazards appear as she described them: a loose rug, no night light. The assessment lists contributors in order of how modifiable each is, and the plan follows the CDC STEADI sequence of screen, assess, intervene.

Reading the NRNP 6540 Week 3 rubric

A fall either has several causes or it has been under-examined. The note that blames a rug and recommends removing it has found one contributor out of five. This example builds a list from examination, medications, and environment before deciding anything. The syncope question earns separate credit, because a fall preceded by lightheadedness needs that distinction made on the page. Graders check for orthostatic vitals with method, a named gait measure, and a medication review that connects the evening diuretic to the night walk. Plans that restrict activity to prevent falls trade her independence away without addressing a single cause, and graders mark them down along with plans that ignore bone health. Among the sources, the CDC STEADI materials or an equivalent framework are expected.

NRNP 6540 Week 3 help from the desk

Fall notes lose credit when they blame a rug and recommend removing it, having found one contributor out of several. Look for all of them. Another common gap is missing orthostatic vital signs when the history suggests lightheadedness on standing. Measure them lying and standing. Writers also skip the medication review, though evening blood pressure or prostate drugs can cause nighttime falls. Avoid telling her to stop living alone; build a plan that keeps her safe at home. Order contributors by how much can be changed. Include vision and footwear. Close with physical therapy referral and a follow-up visit. Writers also overlook nocturia, which put her on her feet at 2 a.m. in the first place. Address the reason she got up as well as the fall.

Get a NRNP 6540 Week 3 example written to your instructions

Send your Week 3 prompt and rubric and the fall scenario your section posted. A post-fall note comes back reconstructing the event, sorting syncope from a mechanical fall, and ranking contributors by what can change. The first custom sample carries no fee and lands inside 24-48 hours, its sources following the fall framework your materials name.

More NRNP 6540 papers and MSN samples

NRNP 6540 Week 3 questions, answered

Why separate syncope from a mechanical fall?

Because they lead to different evaluations. A fall with loss of consciousness or a cardiac prodrome points toward rhythm and structural heart causes, while a trip or a lightheaded stand points toward orthostasis, gait, and environment. The example argues the distinction from the history in a short paragraph, and graders tend to look for that paragraph before they read the plan.

What is CDC STEADI and why is it cited?

STEADI is the CDC's fall prevention initiative for older adults, organized around screening for fall risk, assessing modifiable factors, and intervening on them. The example cites it for that three-part structure and follows it in the plan. Courses sometimes teach a different framework, and a sample written for your section is organized around whichever model it teaches.

Does the plan tell her to stop living alone?

No. Holding back from that advice is itself graded here. Her stated goal is independence, so the plan targets the modifiable contributors, the diuretic timing, the sleep aid, the rug, the lighting, and her gait, in service of that goal. Recommending a move without addressing any cause tends to read as a failure of the geriatric lens rather than as caution.

Where can I find a free NRNP 6540 Week 3 sample paper?

M.T.'s nighttime fall note appears here with her account, the orthostatic readings, the ranked contributors and the STEADI-based plan.

What caused the fall in NRNP 6540 Week 3?

Her own sequence, standing from bed and the room going gray, points to orthostatic hypotension, with an evening alpha blocker among the contributors.