This page holds a finished NU 611 Unit 5 management plan with named treatment, rejected alternatives, patient specific factors, monitoring and return precautions marked. Searches like "nu 611 unit 5 assignment example", "nu611 unit 5 sample" and "nu 611 unit 5 example" land here.
The NU 611 Unit 5 management plan, in full
Management Plan for New Type 2 Diabetes With Stage 3a Chronic Kidney Disease in a 64-Year-Old Woman
Student Name
Department of Nursing, Herzing University
NU 611: Clinical Decision-Making
Instructor Name
February 17, 2026
Management Plan for New Type 2 Diabetes With Stage 3a Chronic Kidney Disease in a 64-Year-Old Woman
Patient Summary and Problem List
Mrs. L. is a composite 64-year-old retired librarian seen in primary care after routine laboratory work. Her hemoglobin A1C is 8.4%, confirmed on repeat, and she has no symptoms of hyperglycemia. Two kidney function results taken three months apart both show an eGFR of 52, and a spot urine sample shows an albumin-to-creatinine ratio of 180 mg/g. Blood pressure averages 146/88 on home readings. Body mass index is 32. She takes amlodipine 5 mg daily and no other prescription medications. She lives alone on a fixed income, drives, and manages her own medications reliably. She has no history of heart failure, pancreatitis, or genital infections.
Problems, in the order the plan addresses them: (1) type 2 diabetes, newly diagnosed, above goal; (2) chronic kidney disease stage G3a with moderately increased albuminuria (A2); (3) hypertension, above goal on a single agent; (4) obesity; (5) cardiovascular risk reduction. The kidney problem is listed second rather than as a complication because it changes the treatment of the first and third problems.
Problem 1: Type 2 Diabetes
Goal: A1C below 7.0%, individualized for a healthy 64-year-old without hypoglycemia risk factors. Intervention: metformin extended release 500 mg by mouth once daily with the evening meal for one week, then 1,000 mg once daily, increasing to 1,500 mg daily at week four if tolerated. Metformin remains the usual starting agent, and at an eGFR of 52 it can be used at full dose with kidney function monitored at least every three to six months (American Diabetes Association Professional Practice Committee, 2024). The extended-release form was chosen because gastrointestinal side effects are the most common reason patients stop metformin.
Second agent: empagliflozin 10 mg by mouth once daily, started at the same visit rather than added later. When diabetes coexists with reduced kidney function and the eGFR is 20 or above, a sodium-glucose cotransporter 2 inhibitor is recommended for kidney and cardiovascular protection, independent of the A1C (Kidney Disease: Improving Global Outcomes [KDIGO] Diabetes Work Group, 2022). Its glucose-lowering effect is modest at her level of kidney function, but that is not why it is being given.
Rejected alternative: a sulfonylurea such as glipizide. It is inexpensive, which matters on her income, and it lowers A1C effectively, but it carries a risk of hypoglycemia in a woman who lives alone and drives, and it does nothing to protect her kidneys or heart. Semaglutide, or another agent in the GLP-1 receptor agonist class, came up as well and was deferred rather than rejected; it would support weight loss and has cardiovascular benefit, but she prefers to avoid injections at this stage and the cost under her plan is high. It remains the next step if A1C is above goal at three months.
Patient factors that decided the choice: her kidney function made the kidney-protective agent a priority; her living situation made hypoglycemia risk decisive against a sulfonylurea; her cost concerns were addressed by confirming her plan covers empagliflozin with a manageable copay before prescribing. Education, in her words: "The metformin is for your sugar. The second pill protects your kidneys and heart as well as lowering sugar. It makes you pass more urine, so drink water through the day, and keep the genital area clean and dry because it can cause yeast infections. If you are ever sick with vomiting or can't eat or drink, skip both pills that day and call us."
Problem 2: Chronic Kidney Disease With Albuminuria
Goal: slow progression, reduce albuminuria, and avoid nephrotoxic exposures. Intervention: lisinopril 10 mg by mouth once daily, which also serves problem 3. A renin-angiotensin system inhibitor titrated to the highest tolerated dose is recommended in people with diabetes, hypertension, and albuminuria (KDIGO Diabetes Work Group, 2022). She is told to stop over-the-counter nonsteroidal anti-inflammatory drugs and use acetaminophen for pain. Monitoring: a basic metabolic panel for potassium and creatinine one to two weeks after starting lisinopril, because a creatinine rise of up to 30% is expected and acceptable, while a larger rise or potassium above 5.5 mmol/L requires review. The urine albumin-to-creatinine ratio is rechecked at three months.
Problem 3: Hypertension
Goal: blood pressure below 130/80 (Whelton et al., 2018). Intervention: lisinopril as above, continuing amlodipine 5 mg. The guideline supports a target below 130/80 for adults with diabetes or chronic kidney disease, and combining a renin-angiotensin system inhibitor with a calcium channel blocker is a standard two-drug regimen. A thiazide-type diuretic was the alternative second agent and was not chosen, because the albuminuria gives the renin-angiotensin system inhibitor a kidney indication the diuretic lacks, and because starting a diuretic together with empagliflozin, which also causes fluid loss, would raise her risk of dizziness and dehydration in the first weeks. Monitoring: home blood pressure twice daily for one week before the four-week visit, with her home cuff checked against the clinic device at that visit.
Problems 4 and 5: Weight and Cardiovascular Risk
Nonpharmacological management is given the same weight as the prescriptions. She is referred to diabetes self-management education and to a registered dietitian, both covered by her plan, with the specific goal of a 5% weight loss over six months. She walks with a friend twice weekly and agrees to add a third walk. For cardiovascular risk, moderate-intensity atorvastatin 20 mg by mouth nightly is started, because adults aged 40 to 75 with diabetes are candidates for statin therapy regardless of calculated risk (American Diabetes Association Professional Practice Committee, 2024). A fasting lipid panel is drawn before starting and rechecked in 8 to 12 weeks.
Monitoring, Follow-Up, and Return Precautions
Laboratory monitoring: basic metabolic panel at 1 to 2 weeks; A1C, eGFR, and urine albumin-to-creatinine ratio at 3 months; lipid panel at 8 to 12 weeks; vitamin B12 annually while on metformin. Follow-up: a visit at four weeks to review tolerance, home blood pressures, and the metabolic panel, because three new medications are starting and adherence problems are most likely early. A three-month visit follows to review A1C and decide on the injectable agent.
Referral thresholds: nephrology if eGFR falls below 30, if the albumin-to-creatinine ratio rises above 300 mg/g despite treatment, or if potassium stays elevated. Return precautions, written for her: call the same day for dizziness when standing, very little urine, vomiting that stops you from drinking, or painful burning with urination; go to the emergency department for rapid breathing, severe belly pain, or confusion, which can signal a rare but serious acid buildup with the kidney pill.
References
American Diabetes Association Professional Practice Committee. (2024). 9. Pharmacologic approaches to glycemic treatment: Standards of care in diabetes-2024. Diabetes Care, 47(Suppl. 1), S158-S178. https://doi.org/10.2337/dc24-S009
Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. (2022). KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney International, 102(5S), S1-S127. https://doi.org/10.1016/j.kint.2022.06.008
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Jr., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., Sr., ... Wright, J. T., Jr. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065
What a finished NU 611 Unit 5 management plan looks like
The finished plan is specific enough to be acted on. Problems are listed, and each carries its own block. Where a medication is chosen, it appears with drug, dose, route, frequency and duration, followed immediately by the reason this agent rather than the obvious alternative. Patient factors that changed the choice are stated plainly, whether renal function, pregnancy or lactation, age, interacting medications, cost or the ability to attend follow-up. Non-pharmacological management is given real space rather than a closing sentence. Education appears in the words the patient would actually hear. Monitoring names the parameter, the method and the timing. The plan ends with a follow-up interval that carries a reason, referral criteria, and the findings that should bring the patient back immediately.
How a NU 611 Unit 5 example is structured
The example is built so that every element points back at a decision. It opens with the problem list, since a plan without ordered problems tends to treat the loudest one. Each problem then gets a block that moves from goal to intervention to justification, and the justification is where the rejected alternative is named and dismissed for a stated reason. Patient factors are handled inside the block that they affect rather than gathered into a general paragraph, which keeps them consequential. Guideline recommendations are cited where they apply, and any departure from a guideline is defended openly rather than passed over. Monitoring follows treatment directly, because an intervention with no parameter attached cannot be evaluated. The plan closes with follow-up, referral thresholds and return precautions written for the patient rather than for the chart.
Treatment named to the dose
Drug, dose, route, frequency and duration appear together, since a plan naming only a drug class has not yet made the decision it claims.
The rejected alternative dismissed openly
Each choice states what else was reasonable and why it was not selected, which is where the reasoning criterion finds most of its evidence.
Patient factors placed where they act
Kidney function, pregnancy, interactions, cost and adherence appear inside the decision they altered rather than in a general paragraph of considerations.
Monitoring with parameter and timing
Every intervention names what will be measured, how and when, so the plan can be judged later rather than only intended now.
Return precautions in patient words
The findings that should bring this person back immediately are written in language a patient would understand and act on without translation.
Where marks go in NU 611 Unit 5
Plans lose marks by staying generic. A management section naming drug classes with no dosing gives the prescribing criterion nothing to score, and it is the single most common gap in this deliverable. Plans that would read identically for any patient with this diagnosis are the second loss, because the whole point is the adjustment this person required. Citing a guideline and then quietly departing from it, with no acknowledgment, costs more than departing from it deliberately and saying why. Monitoring left as follow-up in the usual interval, with no parameter and no reason for the timing, leaves an easy criterion unearned. Education written in clinical vocabulary fails the patient centered criterion. The strongest plans name the factor that made the standard choice wrong here.
Get a NU 611 Unit 5 example written to your instructions
Send the Unit 5 instructions and the rubric from your NU 611 classroom, plus the case, the diagnosis you settled on and any guideline your section requires. We write a custom example with named treatment, rejected alternatives, monitoring and return precautions worked through, and return it in 24 to 48 hours. The first custom sample is free.
NU 611 Unit 5 questions, answered
Do I have to name a specific drug and dose?
In most graduate nursing sections, yes, and the rubric usually says so. Naming a class demonstrates recognition; naming an agent with dose, route, frequency and duration demonstrates a decision. Support the choice with current clinical guidance and state the patient factors behind it. If your instructions restrict prescribing detail for a particular case, follow them and defend the class level choice just as carefully.
Which guidelines should the plan cite?
Current national or specialty guidance for the condition, cited properly, in preference to review articles or summary sites. Use the version in force now rather than one you already have on hand, since recommendations change. Where two credible guidelines disagree, say so and choose one with a reason, which usually reads stronger than presenting a recommendation as though it were uncontested.
How does this differ from the workup earlier in NU 611?
The workup argues what should be investigated and what each result would change, ending before treatment. This deliverable begins after a diagnosis is settled and defends what will now be done about it, including monitoring and follow-up. The habit of justification carries across both, but a plan that spends its length re-arguing test selection loses the treatment criteria it should be earning.