NRNP 6566 Week 10 Day-Two Progress Note Example

Course	NRNP 6566 Advanced Care of Adults in Acute Settings I
Week	Week 10
Paper type	Hospital progress note
Length	About 770 words, 5 pages
Format	APA 7 student paper
School	Walden University
Program	MSN Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)
Updated	October 2026

Free sample paper for NRNP 6566 Week 10

Hospital Day 2 Progress Note: Right Leg Cellulitis, Erythema 2 cm Inside the Admission Line

Student Name

College of Nursing, Walden University

NRNP 6566: Advanced Care of Adults in Acute Settings I

Instructor Name

Month Day, Year

What this page is doingThe title states the one measured comparison the note turns on. A progress note is graded on whether it shows progress, and a margin described against the line drawn at admission is the evidence for it.

Hospital Day 2 Progress Note: Right Leg Cellulitis, Erythema 2 cm Inside the Admission Line

Overnight Interval

Composite case, the same 58-year-old truck driver admitted yesterday with right lower leg cellulitis (see the admission history and physical). Overnight: maximum temperature 37.9 C at 22:00, afebrile since 02:00; no rigors. He slept 6 hours. Pain in the leg 4 of 10 this morning, down from 7 at admission; he walked to the bathroom with the leg less sore. No new symptoms; no diarrhea on cefazolin. He asked whether he can drive again next week.

A Comparative Examination

Temperature 37.1 C; heart rate 84 (104 at admission); blood pressure 128/76; respiratory rate 16; oxygen saturation 98% on room air.

Right lower leg, compared with the margin drawn at 21:40 on admission: erythema now lies inside the line on all sides, 2 cm inside at the proximal edge and 1 to 1.5 cm inside laterally and medially, measuring 11 by 9 cm against 14 by 11 cm yesterday. Warmth: reduced, still warmer than the left leg. Swelling: less, skin creases returning at the ankle. Tenderness: limited to the central area. Looked for and absent: fluctuance, purulence, bullae, skin darkening or necrosis, crepitus, pain beyond the margin, new lymphangitic streaking. Right inguinal nodes: smaller and no longer tender. Interdigital maceration between the right fourth and fifth toes: less moist after terbinafine and drying.

Photograph taken at the same angle as yesterday's for comparison.

What this page is doingThe examination is recorded against the admission finding, with measurements. A margin described only as improving, with no reference to the line, is the classic loss in a day-two note.

Data With Direction

White cell count 14.2 to 11.0 x 10^9/L, falling. Creatinine 1.0 to 1.0 mg/dL, stable. Glucose: fasting 176 mg/dL; point-of-care values 168 to 214 mg/dL over the past 24 hours on basal and correction insulin, down from 238 on admission but above target. A1c returned 8.6%. C-reactive protein not repeated; it would not change management today.

Problems With Status Labels

1. Nonpurulent cellulitis, right lower leg: improving. Evidence: afebrile for 7 hours; heart rate normal; erythema receding inside the drawn margin on every side; white cell count falling. None of the triggers set at admission for adding MRSA coverage has occurred: no spread beyond the margin, no purulence, no fall in blood pressure. Streptococci and methicillin-sensitive Staphylococcus aureus remain the likely organisms (Raff & Kroshinsky, 2016). Because redness can lag behind control of the infection, and can look briefly worse in the first day of treatment, the label rests on four measures moving together, temperature, heart rate, white cell count, and the margin, rather than on the margin alone.

2. Interdigital tinea pedis, portal of entry: improving. Evidence: drier web space.

3. Type 2 diabetes with hyperglycemia: unchanged, above target. Evidence: glucose 168 to 214 mg/dL; A1c 8.6%.

4. Hypertension: unchanged, controlled. Evidence: 128/76.

5. Tobacco use: unchanged. Using the nicotine patch; 1 cigarette craving episode overnight.

Continue, Stop, Start

Cellulitis. Continue intravenous cefazolin through today. Start: plan to switch to oral cephalexin tomorrow if he remains afebrile and the margin keeps receding, since he is clinically improving and can take oral medication. Total duration 5 days from the first dose, extended only if improvement stalls; in a randomized trial of uncomplicated cellulitis, 5 days of therapy produced the same cure rate as 10 days in patients who had improved by day 5 (Hepburn et al., 2004), and the IDSA guideline recommends 5 days, extended if infection has not improved (Stevens et al., 2014). Continue leg elevation. Stop: the admission trigger for vancomycin is retired, since the cellulitis is improving.

Tinea pedis. Continue topical terbinafine for 2 weeks; start a daily foot check at home, which his wife agreed to help with.

Diabetes. Continue basal insulin; increase the dose by 10% tonight because fasting glucose is above target. Start: metformin restarts tomorrow if he is eating normally. Start: discuss the empagliflozin he stopped for urinary frequency while driving, and whether a different agent suits his work.

Hypertension. Continue lisinopril, no change.

Tobacco. Continue nicotine patch; start a referral to the state quitline, which he accepted.

Discharge: likely tomorrow after the oral switch. His driving question: he may drive once he can press the brake firmly without pain, and he should stop every 2 hours to walk and elevate the leg during the first week back.

Teaching started today for discharge: how to check the leg each evening against the photograph on his phone; signs that mean he should call the same day, namely redness spreading past today's line, fever of 38.0 C or higher, new blisters, or pain that grows instead of settling; and the connection between his toe web skin, his ankle swelling, and this infection, since keeping both under control is what lowers the chance of a second episode.

References

Hepburn, M. J., Dooley, D. P., Skidmore, P. J., Ellis, M. W., Starnes, W. F., & Hasewinkle, W. C. (2004). Comparison of short-course (5 days) and standard (10 days) treatment for uncomplicated cellulitis. Archives of Internal Medicine, 164(15), 1669-1674. https://doi.org/10.1001/archinte.164.15.1669

Raff, A. B., & Kroshinsky, D. (2016). Cellulitis: A review. JAMA, 316(3), 325-337. https://doi.org/10.1001/jama.2016.8825

Stevens, D. L., Bisno, A. L., Chambers, H. F., Dellinger, E. P., Goldstein, E. J., Gorbach, S. L., Hirschmann, J. V., Kaplan, S. L., Montoya, J. G., & Wade, J. C. (2014). Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 59(2), e10-e52. https://doi.org/10.1093/cid/ciu296

Reading the NRNP 6566 Week 10 instructions

For Week 10, NRNP 6566 typically wants a daily progress note on a patient admitted earlier in the course. You summarize the overnight interval, examine with direct comparison to the prior day, report data with its trend, label each problem's status and write the plan as actions to continue, stop or start. Faculty penalize notes copied forward from the admission document. Cite guidelines where they decide a change, such as the switch from intravenous to oral antibiotics, in APA 7. Unchanged problems still appear, briefly. A discharge condition, a measurable point at which he can go home, belongs in the note. Keep the note short; a progress note is not a second admission history. Times matter, so date and time the key observations.

How this NRNP 6566 Week 10 example is built

A day-two note is short by design, usually a page and a half. It opens on the interval: events overnight, new symptoms, and what the patient reports about pain and function. The examination is focused and comparative, with the margin of redness measured against the line drawn at admission, and warmth, swelling and signs of spread or abscess looked for and recorded as present or absent. Data returned since admission appear with their direction of change rather than as isolated values. The assessment runs by problem, each entry marked improving, unchanged or worse, with the evidence for that label. The plan for each problem lists what goes on, what ends and what begins, each change carrying one sentence of reasoning. The last line states the condition for discharge. Her case is a teaching composite.

NRNP 6566 Week 10 rubric: what earns full marks

Progress notes are marked on whether they show progress. Most costly of all is a copied-forward note, identical in structure and wording to the admission document, which tells a grader nothing about the second day. Examinations recorded without reference to the earlier finding lose the comparison the week is teaching, and a leg margin described as improving with no measurement is the classic example. Assessments listing problems without a status label leave the reader to infer direction. Plans that restate every item from admission, with changes buried inside, score lower than short plans that isolate what is new. A missing discharge condition costs the forward-looking line in most rubrics. Minor losses include results reported without time stamps and overnight events summarized as uneventful with nothing specific recorded.

NRNP 6566 Week 10 help: mistakes that cost marks

The most costly fault here is a copied-forward note whose structure and wording match the admission document. Rewrite each section around what changed. Another common gap is an examination described as if new, with no comparison to the marked line. Measure and compare. Writers also report laboratory values without direction, so the reader cannot tell whether the white count is falling. Give the trend. Avoid leaving stable problems out entirely; list them with a status. Name the condition for discharge, such as afebrile for 24 hours with retreating redness and oral intake. Check that the temperatures and times agree across sections. Close with the plan for tomorrow's review and who will reassess the leg.

Get a NRNP 6566 Week 10 example written to your instructions

Attach the Week 10 prompt and rubric, along with the admission note if your section builds day two on an earlier week's case, and a progress note example comes back measured against it. The first one is free and returns in 24 to 48 hours. The cellulitis, the marked margin and the patient herself were made up for the sample.

More NRNP 6566 papers and AGACNP samples

NRNP 6566 Week 10 questions, answered

Why use cellulitis for a progress note example?

Because its examination is measurable and comparable from day to day, which makes interval change visible on the page. A marked margin and a documented measurement give the day-two note something concrete to compare against. If your section builds this week on a different admission, the example follows that case instead and finds its equivalent comparative finding.

Should unchanged problems still appear?

Yes, briefly. The example lists every active problem in admission order and gives unchanged ones a status label and a line, so a grader can see they were reviewed. What it avoids is restating their full plans. A problem missing entirely reads as forgotten, while one restated at length buries the changes the note exists to record.

What counts as a discharge condition?

A stated clinical state the patient needs to reach before leaving, written so it can be checked, rather than a date or a general hope for improvement. The example ties its condition to the measurable examination and to function. It is a documentation element of a graded note, not a discharge recommendation for anyone real.

Where can I find a free NRNP 6566 Week 10 sample paper?

The day-two cellulitis progress note is on this page with the overnight interval, the comparative examination, trended data, status labels and the continue, stop, start plan.

How is the leg compared in NRNP 6566 Week 10?

Against the line drawn at admission, with redness now 2 cm inside it, rather than described from scratch.