| Course | NU 673 Psychiatric Mental Healthcare I |
|---|---|
| Unit | Unit 8 |
| Paper type | Serial encounter record |
| Length | About 530 words, 4 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Psychiatric Mental Health Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 673 Unit 8
Serial Encounter Record: Six Visits Over Eleven Weeks for Postpartum Depression With Intrusive Thoughts, Read as a Series
Student Name
Department of Nursing, Herzing University
NU 673: Psychiatric Mental Healthcare I
Instructor Name
April 8, 2026
Serial Encounter Record: Six Visits Over Eleven Weeks for Postpartum Depression With Intrusive Thoughts, Read as a Series
Patient and Format
Ms. A., a composite first-time mother of 34, was first seen at five months postpartum, breastfeeding, whose depression came with unwanted images of harm coming to her son. Each visit is recorded under the same four headings, so that changes between visits stand out. The Edinburgh Postnatal Depression Scale was completed at every visit (Cox et al., 1987).
The Encounters
The table lists each visit under the same headings.
| Visit | What has changed | What was found | What was decided | What was arranged |
|---|---|---|---|---|
| 1, January 16 | First visit; leave ends in 10 days; husband found her crying in the car | Edinburgh 19; intrusive harm images daily, unwanted; passive thought son better off with another mother; no suicidal intent; thyroid normal | Depressive episode with intrusive thoughts; start sertraline 25 mg | Safety plan with husband; perinatal therapy referral; letter for leave extension; weekly visits |
| 2, January 23 | Tolerating sertraline; mild nausea first 3 days | Edinburgh 17; intrusive thoughts daily; sleeping 5 hours | Increase sertraline to 50 mg | Therapy starts January 30 |
| 3, February 6 | Leave extended; returns to work February 9 | Edinburgh 15; intrusive thoughts 4 to 5 times a week; sleeping 6 hours; anxious about work | Continue 50 mg | Discussed plan for first work week |
| 4, February 20 | Two weeks back at work; hard first week | Edinburgh 13; intrusive thoughts about twice a week; enjoying time with son again; passive thought absent 2 weeks | Continue 50 mg; lengthen interval to 2 weeks | Triggers for earlier contact written down |
| 5, March 6 | Steady at work; baby sleeping through the night | Edinburgh 10; intrusive thoughts once in 2 weeks; still low energy most afternoons | Increase sertraline to 75 mg, aiming for remission rather than partial response | Pediatrician informed of dose change; visit in 4 weeks |
| 6, April 3 | Sister visited; went out with friends for first time since birth | Edinburgh 6; no intrusive thoughts in 3 weeks; energy improved | Continue 75 mg for at least 6 months after remission | Visits every 6 weeks; therapy tapering to every 2 weeks |
Reading the Series
Read as a series, the record shows four things no single visit could.
First, the course of her Edinburgh score: 19, 17, 15, 13, 10, 6. The decline was steady rather than sudden, about two points per visit on 50 mg, then a larger drop after the increase to 75 mg. On any one visit, a two-point change might have looked like noise; across six visits, it is a clear trend, and the acceleration after the dose increase supports that decision.
Second, the intrusive thoughts fell in parallel with her depression, from daily to twice a week to none. That parallel is informative. Unwanted harm-related thoughts are common in new mothers (Fairbrother & Woody, 2008), and when they rise and fall with depression, they are more likely part of the depressive episode than a separate obsessive-compulsive disorder requiring its own treatment. A single visit could not have shown that relationship.
Third, the return to work did not cause a setback in the scores, although she described the first week as hard. The Edinburgh score kept falling from visit 3 to visit 4. Without the series, her report of a hard week might have been read as a relapse.
Fourth, sleep improved before mood. She was sleeping six hours by visit 3, when her score had fallen only four points. Sleep often improves early in treatment, and noticing it gave her evidence of progress when mood had not yet shifted.
What the Series Changes Going Forward
The diagnosis is refined: the intrusive thoughts are best understood as part of the depressive episode, and no separate treatment for obsessive-compulsive disorder is planned, though they will be asked about at each visit, since their return would be an early sign of relapse. The maintenance plan follows guidance to continue treatment after remission and to coordinate care with her obstetric and pediatric clinicians (American College of Obstetricians and Gynecologists [ACOG], 2023). The early improvement she showed in the first weeks, which predicted the eventual response she achieved (Szegedi et al., 2009), will be noted in her record in case of a future episode, including a future pregnancy, when the same medication at the same dose would be a reasonable first choice.
What to Watch in the Next Series
Weaning, which she plans at about 12 months, and any future discussion of stopping sertraline will be the next decision points. Her Edinburgh score, intrusive thoughts, sleep, and the passive thought about her son will continue to be recorded at every visit in the same format, so that an early sign of relapse is visible across visits as clearly as the recovery was.
References
American College of Obstetricians and Gynecologists. (2023). Screening and diagnosis of mental health conditions during pregnancy and postpartum (Clinical Practice Guideline No. 4). Obstetrics & Gynecology, 141(6), 1232-1261. https://doi.org/10.1097/AOG.0000000000005200
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150(6), 782-786. https://doi.org/10.1192/bjp.150.6.782
Fairbrother, N., & Woody, S. R. (2008). New mothers' thoughts of harm related to the newborn. Archives of Women's Mental Health, 11(3), 221-229. https://doi.org/10.1007/s00737-008-0016-7
Szegedi, A., Jansen, W. T., van Willigenburg, A. P. P., van der Meulen, E., Stassen, H. H., & Thase, M. E. (2009). Early improvement in the first 2 weeks as a predictor of treatment outcome in patients with major depressive disorder: A meta-analysis including 6562 patients. The Journal of Clinical Psychiatry, 70(3), 344-353. https://doi.org/10.4088/JCP.07m03780
Reading the NU 673 Unit 8 instructions
Unit 8 asks you to present a series of encounters with one patient and analyze what the series shows. Expect to describe the patient and format, record each visit under consistent headings, identify patterns across visits, explain what the series changes and plan what to watch next. Many versions ask how many encounters to include; four to eight is common. Check whether your section allows visits from your clinical hours, de-identified. Consistent headings make patterns visible. A validated measure at each visit gives the series a spine. The analysis should show something no single visit could, such as the relationship between two symptoms over time, and should change how the case is understood going forward.
How this NU 673 Unit 8 example is built
The record opens with the patient and the format, explaining the headings used for each visit. The table presents six visits in the same structure, which lets the reader scan across time. The reading section identifies four patterns, each supported by entries in the table. One shows that intrusive thoughts tracked mood closely, which supports seeing them as part of the depressive episode. Another shows the timing of response to sertraline. The section on what the series changes refines the diagnosis and plan. The final section looks ahead to weaning and eventual medication decisions, explaining why those will be the next points of risk. The record reads as analysis rather than a list of visits.
Reading the NU 673 Unit 8 rubric
Herzing's rubric for a serial encounter record usually covers the consistency of encounter documentation, use of measures, identification of patterns, clinical implications, forward planning and writing. Pattern identification carries the most weight, since the assignment exists to show what a series reveals. Consistency points reward the same headings at every visit. Measure criteria look for a validated scale tracked over time. Implications earn credit when patterns change diagnosis or plan. Forward planning points go to specific future risks. A readable table helps. ACOG's guidance and Fairbrother and Woody's study of infant-related harm thoughts belong in the APA 7 list. Graders also check that the forward plan follows from the patterns rather than from general knowledge about postpartum care.
NU 673 Unit 8 help: mistakes that cost points
A common Unit 8 weakness is a visit-by-visit list that never reads the visits together. Another frequent problem is inconsistent headings, which hide patterns. Students often omit a measure, so change is described rather than shown. Patterns are claimed without pointing to the visits that show them. The record does not say what changed in the diagnosis or plan. Forward planning is generic. The series is too short to show a trend. Finally, show something no single visit could, because graders judge the record by whether the series view adds insight, such as intrusive thoughts fading with mood rather than independently. Visits of very different lengths or formats also make comparison harder, so keep the headings identical even when a visit was brief.
Get a NU 673 Unit 8 example written to your instructions
Send the Unit 8 instructions and the rubric from your NU 673 classroom, with the number of encounters it should cover and any earlier pieces to build on. We write a custom example holding one format across every visit, describing the intervals between them, and reading the series for the trend and the turning point. First custom sample free, delivered in 24 to 48 hours.
More NU 673 papers and PMHNP samples
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- NU 673 Unit 4: Consent and confidentiality brief
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- NU 673 Unit 6: Follow-up interval rationale
- NU 673 Unit 7: Interdisciplinary consultation note
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- NU 672 Unit 8: Therapy episode portfolio
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NU 673 Unit 8 questions, answered
How many encounters should the series contain?
Three or four is usually enough for a trend to appear and few enough to write properly, unless the instructions set a number. Two visits give you a comparison rather than a series, and six thin out into summaries. What matters is that something changes across them, since a series in which nothing moves has no reading to offer at the end.
Can the series come from my clinical hours?
No. Compose a composite series and label it as such. The encounters you take part in belong to the service, the supervising clinician and the person in the room, and the paperwork attached to them, logs, evaluations and sign-offs, is yours to complete inside your placement. A constructed series also lets you place the turning point where the analysis needs it.
Should every visit be the same length?
The format stays identical; the content does not have to. A visit where little changed can be two short paragraphs under the same headings, and the brevity is itself informative. What breaks the record is varying the headings, because then a reader cannot tell whether something was absent at that visit or simply not written down.
Where can I find a free NU 673 Unit 8 sample paper?
This page holds the whole NU 673 Unit 8 serial record free, six visits in one table and four patterns read across them. A serial record for another patient can be prepared on request.
What does a series of psychiatric visits show that one visit cannot?
It shows how symptoms move together over time, how fast treatment works and whether a diagnosis holds. In this sample the intrusive harm thoughts faded as mood lifted, supporting them as part of postpartum depression rather than separate OCD.