| Course | NSG 123 Medical-Surgical Nursing I |
|---|---|
| Unit | Unit 3 |
| Paper type | Nursing intervention rationale |
| Length | About 780 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 123 Unit 3
Six Nursing Actions and Two the Case Does Not Call For: An Intervention Rationale for Nonoperative Care of Diverticulitis With a Drained Abscess
Student Name
Department of Nursing, Herzing University
NSG 123: Medical-Surgical Nursing I
Instructor Name
January 30, 2026
Six Nursing Actions and Two the Case Does Not Call For: An Intervention Rationale for Nonoperative Care of Diverticulitis With a Drained Abscess
The Case at This Point
The composite 58-year-old dispatcher from Units 1 and 2 is on hospital day 2. A percutaneous drain was placed in the pericolic abscess this morning. She remains nothing by mouth with intravenous fluids and antibiotics. Temperature 38.1 °C, heart rate 96, pain 6 of 10. Potassium 3.4 mmol/L, magnesium 1.5 mg/dL. Each entry below gives the nursing action in the wording of the course text (Hinkle et al., 2022), then three lines: the finding that puts it in play, the change expected, and what would show the change occurred. Decisions that belong to the prescriber are named as such.
Entry 1: Monitor vital signs and abdominal assessment every four hours and with any change in pain
Finding: fever of 38.1 °C and a heart rate of 96 on day 2, with a known abscess now drained. Expected change: detection of worsening infection or perforation early rather than late. Evidence of change: a documented trend of falling temperature and heart rate over 48 hours; or, if things worsen, a record showing that rising heart rate, new rigidity, or spreading pain were reported within the hour. Guidelines treat failure of nonoperative management, shown by worsening signs despite antibiotics and drainage, as a reason to reconsider surgery (Hall et al., 2020); the nursing record is how that failure is seen.
Entry 2: Maintain the percutaneous drain and record output and character each shift
Finding: drain placed this morning; 85 mL of cloudy fluid in the first 24 hours. Expected change: continued drainage of the abscess, with falling volume and clearing fluid as it empties. Evidence of change: shift records showing decreasing output and a change from cloudy to thinner fluid; the drain secured and not kinked on each check. Flushing the drain, and how often, is ordered by the interventional radiology team; nursing performs and records it as ordered.
Entry 3: Administer intravenous antibiotics on schedule and monitor for adverse effects
Finding: complicated diverticulitis with an abscess and a systemic response. Expected change: control of the infection. Evidence: falling temperature and white count over 48 to 72 hours; doses documented within the scheduled window; no rash, diarrhea, or infusion-site reaction. The choice of antibiotic and its duration belong to the prescriber.
Entry 4: Monitor potassium and magnesium and administer replacement as ordered, with cardiac monitoring if ordered
Finding: potassium 3.4 and magnesium 1.5, both low, after vomiting and with rising urine output. Expected change: both return to range, magnesium first. Evidence: daily values in range; no palpitations or new irregular pulse. Low potassium can affect heart rhythm and bowel movement (Kardalas et al., 2018); a nurse checking an irregular pulse before each potassium dose is part of the evidence.
Entry 5: Assess pain with a numeric scale and administer analgesia as ordered, with repositioning
Finding: pain 6 of 10, easing from 8 on admission; she lies with knees drawn up. Expected change: pain low enough for her to turn, breathe deeply, and walk. Evidence: pain scores at or below the level she names as tolerable (she chose 4 of 10) after each dose; she walks to the bathroom with the drain bag secured. A sudden rise in pain, rather than a gradual fall, is recorded as a change to report under Entry 1, not only as a pain score.
Entry 6: Teach about the drain, the plan, and warning signs; address her concern about work
Finding: she said, "I can't be off work long." Expected change: she can describe the drain care, the signs to report, and the timeline the team has given her. Evidence: she explains back in her own words, and asks to speak with the case manager about work leave. Expert guidance advises that patients understand their own risks and that decisions about later surgery be personalized to them (Peery et al., 2021); her understanding is the start of that.
Actions the Reading Offers That This Case Does Not Call For
Insert a nasogastric tube to low suction: set aside. The reading lists this for bowel obstruction or persistent vomiting. She has not vomited since day 1 and has no signs of obstruction. It would apply if vomiting returned with a distended abdomen.
Prepare the patient for urgent surgery: set aside at this point. It would apply if she showed signs of free perforation, such as a rigid abdomen, falling blood pressure, or spreading pain, or if she failed to improve after drainage. The decision is the surgeon's; nursing's part is to recognize and report the findings that would prompt it.
References
Hall, J., Hardiman, K., Lee, S., Lightner, A., Stocchi, L., Paquette, I. M., Steele, S. R., Feingold, D. L., & Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. (2020). The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of left-sided colonic diverticulitis. Diseases of the Colon & Rectum, 63(6), 728-747. https://doi.org/10.1097/DCR.0000000000001679
Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022). Brunner & Suddarth's textbook of medical-surgical nursing (15th ed.). Wolters Kluwer.
Kardalas, E., Paschou, S. A., Anagnostis, P., Muscogiuri, G., Siasos, G., & Vryonidou, A. (2018). Hypokalemia: A clinical update. Endocrine Connections, 7(4), R135-R146. https://doi.org/10.1530/EC-18-0109
Peery, A. F., Shaukat, A., & Strate, L. L. (2021). AGA clinical practice update on medical management of colonic diverticulitis: Expert review. Gastroenterology, 160(3), 906-911. https://doi.org/10.1053/j.gastro.2020.09.059
What the NSG 123 Unit 3 instructions ask for
Unit 3 asks you to write rationales for nursing interventions in a specific case. Expect to describe the case, list interventions with the finding that calls for each and the reason, and explain interventions the reading offers that this case does not need. Many versions ask how many interventions to include and whether to list physician orders. Check whether your section distinguishes independent from collaborative actions. Each rationale should connect a finding to a mechanism and an expected effect. Collaborative actions, such as giving ordered antibiotics, belong if the nursing part is clear. Setting aside unneeded actions shows judgment. Teaching and psychosocial support count as interventions. Keep the case consistent with earlier units.
Inside the NSG 123 Unit 3 example
The rationale opens with the case at this point, including the drain and current vital signs. Each entry follows the same structure: action, finding and reason. The monitoring entry explains what signs would show the abscess returning. The drain entry explains why output and character matter. The antibiotic entry includes monitoring for adverse effects. The electrolyte entry links to the Unit 2 trends. The pain entry describes assessment and repositioning. The teaching entry quotes her concern and explains how it is addressed. The set-aside section explains why a nasogastric tube is not needed without vomiting or obstruction. The consistent structure lets the grader check each rationale against the case.
Reading the NSG 123 Unit 3 rubric
Herzing's rubric for an intervention rationale usually covers the case summary, the link between findings and interventions, accuracy of rationales, inclusion of teaching and psychosocial care and judgment about unneeded actions. The link from finding to action carries the most weight, since each intervention must answer something the case shows. Rationale points reward mechanisms and expected effects. Teaching criteria look for content matched to the patient's concerns. Psychosocial points go to actions addressing worry or work. Judgment earns credit when unneeded actions are set aside with reasons. Independent and collaborative actions should be kept apart. A consistent entry format helps. The rationale draws on Hinkle and Cheever and on the ASCRS diverticulitis guideline by Hall and colleagues.
NSG 123 Unit 3 help before you submit
Intervention rationales in Unit 3 often slip by listing standard interventions without tying each to a finding in this case. Another frequent problem is rationales that restate the action, such as monitor vital signs to monitor the patient. Students often list physician orders as nursing actions without the nursing part. Teaching is generic. The patient's concerns are ignored. Unneeded actions are included because the textbook lists them. The case changes from earlier units. Drain care lacks what to record and when to report. Antibiotic entries forget adverse effects such as diarrhea. Finally, set aside what the case does not need, because graders reward judgment about this patient rather than a complete list from the textbook.
Get a NSG 123 Unit 3 example written to your instructions
Send the Unit 3 instructions and the rubric from your NSG 123 classroom, with the case and reading it names. We write a custom example that words each action as the source does, puts the case finding above the purpose, ends every entry at something observable and marks what does not apply. First custom sample free, and it comes back inside 24 to 48 hours.
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NSG 123 Unit 3 questions, answered
Where should the actions come from?
Your course reading and whatever material the instructions name, cited entry by entry. Actions recalled from a job, or from a relative's care, are the common weakness here, since they cannot be traced and often reflect one setting's routine. If your reading and your clinical site differ, write what the reading says and note the difference in a line.
How much detail does each finding need?
Enough that the action would look unfounded without it. Naming the report, the observation or the value that raises the action, with where it appears in the case, is usually one line. What does not work is a general statement that patients with this condition commonly need it, which argues for the condition and not for this patient.
Can the rationale include what I would monitor?
Yes, and in most sections that is the line finishing each entry. Keep it descriptive: what would be observed or recorded to show the change, rather than a schedule somebody could follow. Frequencies and thresholds vary between settings and belong to standing arrangements, so treat any figure you use as something your course materials supplied.
Where can I find a free NSG 123 Unit 3 sample paper?
This page shows the whole NSG 123 Unit 3 intervention rationale for free, six actions with findings and reasons and two set aside. A rationale for your own case can be written on request.
What nursing care does a patient with a diverticular abscess drain need?
Regular vital signs and abdominal checks, drain care with output recorded, antibiotics on schedule, electrolyte monitoring, pain assessment and teaching about warning signs. This sample gives the reason for each.