| Course | NU 345 Health Assessment and Promotion Across the Life Span |
|---|---|
| Unit | Unit 4 |
| Paper type | Health assessment and promotion plan |
| Length | About 1,310 words, 7 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NU 345 Unit 4
Health Assessment and Health Promotion Plan for a 68-Year-Old Man With a 32 Pack-Year Smoking History and Untreated Elevated Blood Pressure
[Author Name]
College of Nursing, Herzing University
NU 345 Health Assessment and Promotion Across the Life Span
Unit 4 Assignment
[Instructor Name]
August 11, 2026
Original model document written by our desk. The patient is a composite built for teaching; no real person, family or clinic is described.
Subjective Data: History, Risk and Life Stage
The patient is a 68-year-old man who came to a community clinic for a wellness visit at the urging of his wife, with no complaint of his own beyond feeling 'slower on the stairs than last year.' He retired 14 months ago after 31 years as a warehouse supervisor. Medical history includes osteoarthritis of both knees, benign prostatic hyperplasia and hyperlipidemia. He takes tamsulosin 0.4 mg daily and ibuprofen 400 mg two or three times most days for knee pain, which he did not list as a medication until asked directly. He smoked about one pack a day for 32 years and stopped six years ago. He drinks two beers on most evenings and more at family gatherings.
Functional history matters more than a symptom list at this age, so it was taken in detail. He climbs 12 stairs to his bedroom and rests at the top, manages all activities of daily living without help, drives in daylight only, and has stopped attending his monthly union breakfast since retiring. He reports two near-falls in the past six months, both on the same uneven porch step, and no fall with injury. He sleeps about six hours and wakes twice to urinate. He denies chest pain, syncope, dyspnea at rest, hemoptysis and unintended weight loss. Life stage is relevant rather than decorative here: this is the review-and-integrity stage of later adulthood, and losing a work role in the same year as a shrinking social circle is a documented risk for both inactivity and low mood.
Social and screening history sets up the plan. He lives with his wife of 41 years in a single-story house with a porch step that has no rail and no outside light. Diet is described as 'whatever is quick,' with a sandwich lunch and a restaurant meal three evenings out of seven. Physical activity is mowing the lawn and walking the dog for about ten minutes at a time. His last colonoscopy was eight years ago with no polyps reported, his last tetanus booster was about twelve years ago, he received an influenza vaccine last autumn, and he has never had an abdominal ultrasound or a lung imaging study. He has no advance directive and has not discussed one.
Objective Findings and What They Mean
Vital signs: temperature 36.8 C, heart rate 78 and regular, respiratory rate 16, oxygen saturation 96 percent on room air, height 178 cm, weight 90 kg, body mass index 28.4, waist circumference 104 cm. Blood pressure was 148/88 mm Hg in the right arm after five minutes seated, and 152/86 mm Hg on a repeat in the same arm at the end of the visit. Two readings at one visit are a signal, not a diagnosis. Both sit above the threshold that prompts action, and the next step is confirmation outside the clinic with home or ambulatory readings before any label or medication is attached, because clinic-only elevation is common at this age and would otherwise be treated as disease.
Focused examination, read cluster by cluster. Cardiovascular: S1 and S2 present, no murmur, no third heart sound, no carotid bruit, pedal pulses 2+ and symmetric, no peripheral edema; taken with the elevated readings, the absence of end-organ signs suggests elevation that is recent or intermittent rather than long-standing. Respiratory: symmetric chest expansion, resonant percussion, breath sounds clear with no wheeze or crackles; a clear examination does not remove lung risk in a former smoker, since screening exists precisely because early disease is silent. Musculoskeletal and gait: bilateral knee crepitus with five degrees of flexion loss, gait speed 0.78 meters per second over four meters, nine repetitions on the 30-second chair stand. Those two numbers, read with the near-falls and the unlit step, place him in the group for whom fall prevention is an active plan rather than advice.
Laboratory findings and what the combination means. Total cholesterol 214 mg/dL, low-density lipoprotein 138 mg/dL, high-density lipoprotein 42 mg/dL, triglycerides 168 mg/dL, creatinine 1.1 mg/dL with an estimated glomerular filtration rate of 68 mL/min/1.73 m2. The lipid panel alone says little at 68. The same numbers combined with age, sex, smoking history and the unconfirmed blood pressure produce a ten-year cardiovascular risk high enough to open a statin conversation, and that combination is the finding rather than any single value. The filtration rate matters for a different reason: it is the number that makes daily ibuprofen a risk worth naming out loud, alongside the blood pressure that drug may be raising. Whispered voice screening failed at 60 cm on the left ear.
Health Promotion Plan: Screening, Immunization and Teaching
Screening is written with the rule that makes him eligible and the interval that follows. Colorectal cancer: the U.S. Preventive Services Task Force recommends screening adults aged 45 to 75, so he qualifies for seven more years; his colonoscopy eight years ago with no polyps places the next examination at the ten-year mark in two years, with annual fecal immunochemical testing offered as the alternative. Lung cancer: annual low-dose computed tomography is recommended for adults aged 50 to 80 with a 20 pack-year history who currently smoke or who quit within the past 15 years; at 68, with 32 pack-years and six years since quitting, he meets every part of that rule and has never been screened. Abdominal aortic aneurysm: one ultrasound is recommended for men aged 65 to 75 who have ever smoked, and he is inside that band now.
Immunization and follow-up carry intervals of their own. The adult schedule places influenza vaccine annually, a tetanus and diphtheria booster every ten years, which is overdue by about two years here, recombinant zoster vaccine as two doses for adults 50 and older, and pneumococcal vaccination for adults 65 and older who have not completed a series. Blood pressure is not treated at this visit. He leaves with a validated upper-arm monitor, written instruction to take two readings each morning and two each evening for seven days, and an appointment in 14 days to bring the log. Daily ibuprofen is addressed at the same visit, with a plan to move to scheduled acetaminophen and a topical agent for the knees.
Teaching is written as actions with numbers attached, because instructions without numbers cannot be measured at the next visit. Physical activity builds toward 150 minutes of moderate activity spread across at least five of every seven days, starting from three ten-minute walks a day, with two sessions of lower-body strength work added because muscle strength is what the chair-stand result identified as weak. Fall prevention is specific: a handrail and a light on the porch step, a safety check of the two rooms he moves through at night, and a repeat gait-speed measure in three months. Two behavior goals were set with him rather than for him: alcohol to no more than one drink on most evenings, and one social activity restarted before the next visit.
References
Centers for Disease Control and Prevention. (2025). Recommended adult immunization schedule, United States, 2025. U.S. Department of Health and Human Services. https://www.cdc.gov/vaccines/hcp/imz-schedules/index.html
Jarvis, C., & Eckhardt, A. (2024). Physical examination and health assessment (9th ed.). Elsevier.
U.S. Preventive Services Task Force. (2019). Abdominal aortic aneurysm: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening
U.S. Preventive Services Task Force. (2021). Colorectal cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
U.S. Preventive Services Task Force. (2021). Hypertension in adults: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening
U.S. Preventive Services Task Force. (2021). Lung cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
Reading the NU 345 Unit 4 instructions
Unit 4 asks you to complete a health assessment and a health promotion plan for an adult. Expect subjective data covering history, risk and life stage, objective findings with interpretation, and a plan for screening, immunization and teaching. Students often ask what it means to interpret a finding. Recording says blood pressure was 148/88; interpreting says what that number means for this patient and what should happen next. Take a functional history, since function matters more than a symptom list in older adults. Write each screening with the rule that makes the patient eligible and the interval that follows. Base the plan on current USPSTF and CDC guidance.
How this NU 345 Unit 4 example is built
The write-up opens with a title page and the patient's reason for the visit. The subjective section covers retirement, medical history, medications, including ibuprofen he did not mention until asked, smoking, alcohol and a detailed functional history. The objective section lists vital signs and body measurements, explains why two elevated readings call for home monitoring and then reads the examination cluster by cluster. The plan section takes colorectal, lung and aortic screening in turn with eligibility and timing, adds immunizations from the adult schedule and gives teaching on blood pressure checks, alcohol and pain relief that spares the kidneys and stomach. References follow, each matched to the recommendation it supports.
Reading the NU 345 Unit 4 rubric
Herzing's rubric for a health assessment and promotion plan typically covers subjective data, objective data, interpretation, screening, immunization and teaching. Interpretation of findings carries the largest share, since the unit is about turning assessment into decisions rather than lists. Subjective points reward history, risk factors and function. Objective criteria look for complete vital signs and focused examination. Screening credit goes to eligibility rules and intervals from current guidance. Immunization points reward the adult schedule applied correctly. Teaching should address the risks found, in words the patient can use at home. Jarvis and Eckhardt's assessment text, USPSTF recommendations on colorectal, lung, aortic and hypertension screening and the CDC adult immunization schedule support the plan.
Common NU 345 Unit 4 mistakes, and how to avoid them
Assessments in NU 345 Unit 4 commonly lose points by recording findings without saying what they mean. Another frequent problem is diagnosing hypertension from two clinic readings. Students often list screenings without eligibility rules or intervals. Over-the-counter medications are missed. Functional history is skipped in older adults. Immunizations are not checked against the current schedule. Teaching is generic rather than tied to findings. Pack-year history is not calculated, so lung screening eligibility cannot be judged. Alcohol use is noted but never counted in drinks per week. Follow-up timing for the blood pressure is left open. Finally, attach a rule and an interval to every recommendation, because graders reward a plan another nurse could follow at the next visit without guessing.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Herzing University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NU 345 Unit 4 questions, answered
What does it mean to interpret a finding instead of recording it?
Recording says the blood pressure was 148/88. Interpreting says what two elevated readings at one visit do and do not establish, and names the next step. The test is simple: after each cluster of findings, answer the question so what in one sentence a reader could act on. Normal findings need that sentence as much as abnormal ones.
How specific do screening recommendations have to be?
Specific enough to check. Name the eligible age band, the risk condition that qualifies your patient, the test and the interval, then say which of those your patient meets. Annual low-dose computed tomography for adults 50 to 80 with a 20 pack-year history is checkable; recommend cancer screening is not, and graders read the difference quickly.
Do I have to use a real patient for this write-up?
Sections differ, so read the assignment page first. Many ask for a composite or a volunteer adult rather than a clinical patient, and none of them want identifiable details in a submitted paper. Build the case from a realistic history, keep the numbers internally consistent, and state once in the paper that the person described is a composite.
Where can I find a free NU 345 Unit 4 sample paper?
Read the complete NU 345 Unit 4 health assessment here at no charge, a 68-year-old man assessed with interpreted findings and a screening plan. Ask for a custom assessment write-up.
When should a former smoker get lung cancer screening?
Current USPSTF guidance recommends yearly low-dose CT for adults 50 to 80 with a 20 pack-year history who smoke now or quit within 15 years. This sample applies that rule to a 68-year-old.