| Course | D118 Adult Primary Care for the Advanced Practice Nurse |
|---|---|
| Task | Task 2 |
| Paper type | Adult primary care management plan |
| Length | About 800 words, 3 pages |
| Format | APA 7 |
| School | Western Governors University (WGU) |
| Program | MSN Family Nurse Practitioner |
| Updated | September 2026 |
Free sample paper for D118 Task 2
Adult Management Plan: Right Lateral Epicondylalgia in a 44-Year-Old Finish Carpenter Who Needs to Keep Working
Student Name
Leavitt School of Health, Western Governors University
D118: Adult Primary Care for the Advanced Practice Nurse, Task 2
Course Instructor
Month Day, Year
Adult Management Plan: Right Lateral Epicondylalgia in a 44-Year-Old Finish Carpenter Who Needs to Keep Working
Diagnosis and Goal of Treatment
Working diagnosis carried from the reasoning task: overuse lateral epicondylalgia of the right elbow. Goal: by 12 weeks, pain-free grip strength on the right within 80% of the left (at least 42 kg, from 38 kg with pain today), and the ability to work full days with pain no higher than 2 out of 10, without a corticosteroid injection.
Pharmacologic Management
Topical diclofenac 1% gel, 4 g applied to the lateral elbow up to four times a day for up to four weeks during flares, chosen over regular oral ibuprofen because he takes lisinopril for hypertension, and topical application limits the kidney and blood pressure effects of oral anti-inflammatories. Acetaminophen 1,000 mg up to three times a day is an alternative for evening aching.
Corticosteroid injection is not recommended. In a randomized trial of patients with lateral epicondylalgia, corticosteroid injection produced lower rates of complete recovery or much improvement at one year than placebo injection (83% versus 96%) and far more recurrences (54% versus 12%) (Coombes et al., 2013). Short-term relief would come at the cost of a worse long-term outcome for a man who needs a durable recovery.
Non-Pharmacologic Management
Exercise is the core of treatment. He will be referred to physical therapy for a progressive loading program of the wrist extensors, starting with isometric holds and moving to slow isotonic exercises, with pain during exercise kept at a tolerable level that settles by the next morning; a multimodal program of exercise, education and, where helpful, manual therapy is the recommended physiotherapy approach (Bisset & Vicenzino, 2015). He will do the home program daily, about 10 minutes, as shown by the therapist.
Load management at work rather than complete rest: grip tools with the palm up when possible, use larger-handled or cushioned grips, alternate hands for lighter tasks, use a battery impact driver instead of hand screwdrivers, keep the elbow slightly bent when lifting and take a two-minute break each hour on repetitive tasks. A counterforce brace worn just below the elbow during heavy work may reduce pain for some patients and is inexpensive to try. Because the condition usually settles over 12 to 18 months even without treatment (Vaquero-Picado et al., 2016), the plan aims to speed recovery and protect his work, not to promise an overnight cure.
Patient Education
What is happening: the tendon that attaches your wrist and finger muscles to the outside of your elbow has been overloaded by months of gripping. It is irritated and not coping with the load, but it is not torn and your joint is healthy.
What helps most: the right amount of exercise, done every day, and changing how you grip at work. Resting completely makes the tendon weaker. Some discomfort during exercises is fine if it settles by the next morning.
About injections: a steroid shot might ease the pain for a few weeks, but research shows the pain is more likely to come back and last longer, so we are not recommending one.
What to expect: most people improve steadily over two to three months with this plan. Call if you develop numbness or tingling in your fingers, weakness when straightening your fingers, swelling or redness of the elbow, fever, or pain that wakes you at night.
Follow-Up
Follow-up visit in six weeks to measure pain-free grip strength, review the home exercise log and check his ability to work. If grip and pain are improving, continue for another six weeks and then taper therapy to a home program. If there is no meaningful improvement at 12 weeks despite good adherence, reassess the diagnosis, obtain elbow radiographs and consider ultrasound.
Referral Criteria and Return Precautions
Refer to sports medicine or orthopedics if symptoms have not improved after three to six months of a well-performed exercise program, if imaging shows a tendon tear, or if neurologic signs appear suggesting radial tunnel syndrome or cervical radiculopathy. Return sooner for fever, a hot swollen elbow, new numbness or weakness, or a sudden pop with loss of strength.
Practical Considerations
He is self-employed and loses income for every day off, so the plan avoids time off work and schedules physical therapy for early mornings twice a week for four weeks, then weekly. His insurance has a $40 copay for therapy visits; the therapist will teach a home program early so that visits can be reduced if cost becomes a barrier. He already owns a cordless impact driver and will buy two cushioned grip sleeves. The gel costs about $15 over the counter.
References
Bisset, L. M., & Vicenzino, B. (2015). Physiotherapy management of lateral epicondylalgia. Journal of Physiotherapy, 61(4), 174-181. https://doi.org/10.1016/j.jphys.2015.07.015
Coombes, B. K., Bisset, L., Brooks, P., Khan, A., & Vicenzino, B. (2013). Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: A randomized controlled trial. JAMA, 309(5), 461-469. https://doi.org/10.1001/jama.2013.129
Vaquero-Picado, A., Barco, R., & Antuña, S. A. (2016). Lateral epicondylitis of the elbow. EFORT Open Reviews, 1(11), 391-397. https://doi.org/10.1302/2058-5241.1.000049
What the D118 Task 2 instructions ask
The second D118 task asks you to write a management plan for the working diagnosis. Most versions ask for the diagnosis and goal of treatment, pharmacologic and non-pharmacologic management with rationale and evidence, patient education, follow-up, referral criteria and practical considerations for the patient's circumstances. Evaluators look for choices justified by evidence and by the patient, not a generic protocol. Drug choices should include dose, duration and why one option was preferred over another. Non-drug management should be specific enough to follow, and follow-up should say what will be measured and when. The plan should also state what success looks like at each visit.
How this D118 Task 2 example is built
The plan opens with the diagnosis carried from Task 1 and a measurable goal. Pharmacologic management gives the drug, dose, frequency and duration, and explains the choice in terms of the patient's risks. Non-pharmacologic management makes exercise the center and describes the progression. Education is written in second person, as the patient would hear it. Follow-up names the interval and what will be checked, such as grip strength and the home exercise log. Referral criteria and return precautions are specific. The practical section adapts timing and cost to a self-employed worker, which shows the plan was written for this person. Each recommendation is tied to the goal set in the first section, which keeps the plan coherent.
Where the D118 Task 2 rubric puts the marks
D118 Task 2 aspects are marked competent, approaching competence or not evident. A goal aspect checks for a measurable aim. Pharmacologic and non-pharmacologic aspects look for evidence-based choices with rationale, doses and durations. An education aspect wants accurate, patient-friendly teaching. Follow-up and referral aspects ask for intervals, measures and clear criteria. A practical aspect rewards adaptation to the patient's circumstances. Evaluators expect current guidelines or trials to support treatment choices and check that doses and durations are correct. Evaluators check doses, frequencies and durations against current references, and they notice when the education section matches the medication and exercise choices exactly. A practical section that adapts the plan to the patient's work or income often separates strong plans from adequate ones.
D118 Task 2 help: what sends it back
Management plans come back most often when drug choices lack rationale. Say why this drug suits this patient better than the alternatives. Second, non-drug treatment is a single line, such as rest and ice. Describe the program and its progression. Third, education is written in clinical language. Rewrite it in words the patient would use. Fourth, follow-up says as needed. Give an interval and the measures you will check. Finally, consider the patient's life. A plan that requires weeks off work may be correct on paper and useless in practice, and evaluators credit plans that fit the person. Read the education section aloud as the patient would hear it.
Get a D118 Task 2 example written to your instructions
Send the D118 Task 2 instructions and the rubric aspects as your course of study states them, along with the case and any diagnosis you established in the earlier half. We write a custom example to those aspects, with therapy, education, follow-up and referral criteria carried through, and return it in 24-48h. The first custom sample is free.
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D118 Task 2 questions, answered
How is the management task different from the diagnostic one?
The earlier document reasons toward a working diagnosis and deliberately stops. This one assumes that diagnosis and commits to what happens next, meaning dose, duration, education content, an interval and referral thresholds. Everything argued as probability in the first half becomes a decision here. Carrying differential reasoning into this task usually leaves the aspects on management and education thin.
Do I need guidelines for every recommendation?
For anything load-bearing, yes. Current professional guidance behind the drug choice, the screening interval and the follow-up timing is what separates a defended plan from a plausible one, and an evaluator reading for evidence-based practice looks there first. General health sites do not carry that weight. Check your instructions for any currency requirement on sources.
Can I include the cost of care in the plan?
Usually yes, and it strengthens the plan. Naming what the therapy costs the patient, whether the pharmacy stocks it and what a missed dose does makes the plan realistic rather than ideal. Hour logs, site agreements and preceptor paperwork sit outside anything we write, without exception, so keep practicum records separate from the submission.
How is the D118 management task different from the diagnostic one?
Task 1 reasons to a working diagnosis; Task 2 treats it. The sample carries the epicondylalgia diagnosis forward and builds medication, exercise, education and follow-up around it.
Where can I find a free D118 Task 2 sample paper?
The full management plan is reproduced above with notes on each choice. Send your D118 instructions and diagnosis, and a first tailored plan is written for you without charge.