| Course | NSG 223 Medical-Surgical Nursing II |
|---|---|
| Unit | Unit 6 |
| Paper type | System interaction map |
| Length | About 490 words, 4 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 223 Unit 6
Six Boxes and Nine Arrows: A System Interaction Map for One Admission, With What Travels Along Each Arrow and What a Nurse Checks Beside It
Student Name
Department of Nursing, Herzing University
NSG 223: Medical-Surgical Nursing II
Instructor Name
February 19, 2026
Six Boxes and Nine Arrows: A System Interaction Map for One Admission, With What Travels Along Each Arrow and What a Nurse Checks Beside It
The Boxes, and Why Others Were Left Off
The map covers the composite dialysis patient with diabetes and a foot infection followed since Unit 1. Six systems are boxed: A, kidneys and fluid; B, heart and circulation; C, glucose and insulin; D, immune response and infection; E, peripheral nerves and vessels of the feet; F, skin and bone of the right forefoot. The lungs are not given a box because in this admission they are affected only through fluid from A and B, and that effect is carried on an arrow. The digestive system is left off because it played no part beyond appetite, which is recorded under C. The brain is left off because his thinking changed only as a consequence of low blood pressure and low glucose, both of which appear on arrows.
The Diagram, as a Table of Arrows
Each row is one arrow. The middle column is the label, written as a mechanism sentence.
| Arrow | What travels along it | What a nurse looks at, listens to, or measures beside it |
|---|---|---|
| E → F | Loss of sensation means pressure and injury go unnoticed; narrowed vessels deliver less blood and oxygen, so a small wound deepens and heals slowly | Foot inspection every shift; skin color and temperature compared with the left foot; any new pain, which would be significant because he usually feels none |
| F → D | Bacteria in the ulcer spread into deeper tissue and bone, triggering the body's inflammatory response | Wound size, redness border marked with a pen, drainage, temperature, white count |
| D → B | Inflammatory signals widen and leak blood vessels, lowering blood pressure and raising heart rate | Blood pressure against his baseline, heart rate, skin warmth, lactate |
| D → C | Infection releases stress hormones that raise glucose and make insulin less effective | Glucose before meals and at bedtime; insulin requirement over 24 hours |
| C → F | High glucose weakens white cell function and slows wound healing | Glucose trend alongside wound progress in the same shift note |
| A → C | Failed kidneys clear insulin slowly, so each dose acts longer and lows are more likely as infection settles | Glucose at 0300; watching for sweating or confusion overnight |
| A → B | Retained fluid expands blood volume and strains the heart; with no urine output, nothing leaves until dialysis | Weight each morning against his target; neck veins; ankle swelling |
| B → lungs (via A) | Extra fluid backs up into the lungs, especially when fluid is given for low blood pressure | Respiratory rate, saturation, crackles at the bases, how many pillows he needs |
| B → A | Low blood pressure during dialysis limits how much fluid can be removed | Blood pressure before and during dialysis; how much was removed against the plan |
Where the Arrows Form a Loop
Two loops matter most. The first runs D → B → A → B: infection lowers blood pressure, low blood pressure limits how much fluid dialysis can remove, and retained fluid strains the heart further. This loop explains the difficult first evening described in Unit 2. The second runs E → F → D → C → F: nerve and vessel damage allow the wound, infection raises glucose, and high glucose slows healing. Guidance on diabetes-related foot infections describes this combination of neuropathy, poor blood supply, and infection as the core of the problem (Senneville et al., 2023). Breaking either loop at any point helps: controlling infection lowers glucose and stabilizes blood pressure, and removing fluid safely allows more room to support the circulation.
How the Map Is Used
The map was drawn on day 2 and updated on day 4, when the arrow from A to C became the most active one, leading to the overnight hypoglycemia recorded in Unit 4. It is used at handoff: the oncoming nurse reads the arrows with the most recent change first, and the outgoing nurse points to any arrow whose assessment was abnormal on the last check, so that attention goes to the active parts of the map rather than to all nine at once. Its value is that it shows why one finding, such as a glucose of 52 at 0300, belongs to several boxes at once, which the course text describes as the central difficulty in caring for patients with several chronic diseases (Hinkle et al., 2022). The insulin arrow follows guidance for diabetes in kidney disease (Rossing et al., 2022). A map drawn once and never updated would mislead, so each arrow's assessment column also records when it was last checked. The patient is a composite.
References
Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022). Brunner & Suddarth's textbook of medical-surgical nursing (15th ed.). Wolters Kluwer.
Rossing, P., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., Sadusky, T., Tandon, N., Tuttle, K. R., Wanner, C., Wilkens, K. G., Zoungas, S., & de Boer, I. H. (2022). KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney International, 102(5, Suppl.), S1-S127. https://doi.org/10.1016/j.kint.2022.06.008
Senneville, É., Albalawi, Z., van Asten, S. A., Abbas, Z. G., Allison, G., Aragón-Sánchez, J., Embil, J. M., Lavery, L. A., Alhasan, M., Oz, O., Uçkay, I., Urbančič-Rovan, V., Xu, Z.-R., & Peters, E. J. G. (2023). IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF/IDSA 2023). Clinical Infectious Diseases. Advance online publication. https://doi.org/10.1093/cid/ciad527
The Herzing NSG 223 Unit 6 instructions
Unit 6 asks you to map how a patient's body systems interact. Expect to choose the systems, explain what was left out, draw arrows between systems with a mechanism on each, identify loops where effects return and explain how the map guides care. Sections differ on whether a drawn diagram is required or a table of arrows will do. Six to eight boxes is a workable size. Each arrow should name what travels along it, such as fluid, glucose or inflammation, in a short mechanism sentence. Loops matter because they can make a patient worse faster than any single problem. Name what a nurse watches at each arrow. Show the map changing as the patient changes, which proves it was used rather than drawn once.
How the NSG 223 Unit 6 example is put together
The map opens with the boxes and the reason for each, plus systems left off and why. The table lists nine arrows, each with a start box, an end box, a mechanism sentence and what the nurse watches. The loops section traces two cycles and explains why they matter most. The usage section shows the map drawn on day 2 and updated on day 4, when a new arrow became most active after surgery. The map links findings across systems so a nurse sees why fixing one problem can help or harm another. Each arrow rests on physiology the course has covered, so the map stays accurate rather than speculative.
NSG 223 Unit 6 rubric: what full points look like
Herzing's rubric for a system interaction map typically covers selection of systems, accuracy of arrows, mechanism labels, identification of loops, nursing watch points and use over time. Accuracy of mechanisms and the loops draw the closest reading, since a wrong arrow could lead a nurse to the wrong action. Selection points reward systems relevant to this patient with reasons for exclusions. Label criteria look for short mechanism sentences, not bare arrows. Watch point points go to specific findings at each arrow. Use over time earns credit when the map is updated. A readable table helps. Surviving Sepsis and KDIGO guidance support the mechanisms.
NSG 223 Unit 6 help before you submit
Interaction maps in Unit 6 commonly lose points by drawing arrows without saying what travels along them. Another frequent problem is including every body system, which makes the map unreadable. Students often miss loops, the most important feature. Watch points are missing or generic. The map is drawn once and never updated. Mechanisms are wrong, such as reversing cause and effect. Excluded systems are not explained. Arrows from treatments, such as insulin or fluid, are left out though they change the picture. Finally, find the loops, because graders reward a map that shows how one problem can feed another and what the nurse can do to break the cycle.
Get a NSG 223 Unit 6 example written to your instructions
Send the Unit 6 instructions and the rubric from your NSG 223 classroom, with the case if one is provided. Your example returns as a labeled diagram plus a written key, assessments attached at each connection, and a closing that names the connection watched hardest. First custom sample free, delivered in 24 to 48 hours.
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NSG 223 Unit 6 questions, answered
Does the map have to be drawn by hand?
Only where your instructions say so. Most sections accept anything legible, including shapes made in a word processor or a free diagram tool, and some ask for an image pasted into the document with the key typed below. What consistently matters is that arrows are labeled and readable at the size you submit, since an unreadable map gets scored on its key alone.
How many systems belong on the map?
The ones the admission runs through, which for most built cases is three or four. Adding systems that play no part gives you arrows you cannot label and assessments you cannot justify. Say in one line why the others were excluded, because a deliberate omission reads as a decision while an unexplained gap reads as an oversight.
Can the same assessment appear on two arrows?
Yes, and saying so is usually worth a sentence. One observation often covers more than one connection, and noticing that sits closer to how nursing time is actually spent than pretending every link needs its own separate check. Attach it to both arrows, then note in the key that the two connections share it.
Where can I find a free NSG 223 Unit 6 sample paper?
Read the complete NSG 223 Unit 6 system interaction map here at no charge, six boxes and nine labeled arrows with two loops. Your own patient's systems can be mapped the same way on request.
How do body systems affect each other in a septic dialysis patient?
Infection lowers blood pressure, which makes dialysis harder to tolerate, which leaves more fluid in the body, which worsens breathing. This sample maps that loop and names what a nurse watches at each step.