| Course | D120 Special Populations Primary Care for the Advanced Practice Nurse |
|---|---|
| Task | Task 2 |
| Paper type | Applied primary care plan |
| Length | About 900 words, 3 pages |
| Format | APA 7 |
| School | Western Governors University (WGU) |
| Program | MSN Family Nurse Practitioner |
| Updated | September 2026 |
Free sample paper for D120 Task 2
Applied Care Plan: New Type 2 Diabetes in a 48-Year-Old Mixteco-Speaking Farmworker During Harvest Season
Student Name
Leavitt School of Health, Western Governors University
D120: Special Populations Primary Care for the Advanced Practice Nurse, Task 2
Course Instructor
Month Day, Year
Applied Care Plan: New Type 2 Diabetes in a 48-Year-Old Mixteco-Speaking Farmworker During Harvest Season
Patient and Circumstances
The patient is a composite 48-year-old man from the farmworker population analyzed earlier, seen at the migrant health center's mobile unit at a labor camp at 7 p.m. He has lived in the county for nine years, picks grapes and stone fruit from June to October and prunes in winter. He speaks Mixteco as his first language and some Spanish, and reads little in either. He has no health insurance and is paid by the bin during harvest. He lives with his wife and three children in a rented trailer; the family has one car, which his wife uses for work. He came because of thirst, frequent urination and blurred vision for two months. A1C is 8.9%, a random glucose 246 mg/dL, blood pressure 146/92 mm Hg on two readings, body mass index 29, and an estimated glomerular filtration rate of 88. Urine albumin is normal. Working diagnoses: new type 2 diabetes and stage 1 hypertension.
Clinical Management, Tested Against His Circumstances
Diabetes medication. First choice: metformin, started at 500 mg once daily with the evening meal and increased by 500 mg each week to 1,000 mg twice daily as tolerated. Metformin is effective, inexpensive and does not cause hypoglycemia, which matters for a man doing heavy work in the heat (American Diabetes Association Professional Practice Committee, 2025). Test against circumstances: cost is about $4 a month through a pharmacy discount program, which he can afford; the extended-release form, which he could take once in the evening, is preferred if the same discount price is available, because a midday dose in the field is likely to be missed.
An SGLT2 inhibitor would ordinarily be attractive for its cardiovascular and kidney benefits, but it is not chosen now. During harvest he works 10-hour days in temperatures above 38 C with limited water breaks, and SGLT2 inhibitors increase urine volume and carry a risk of volume depletion and, rarely, ketoacidosis. Its cost without insurance is also prohibitive. The choice will be revisited in winter if A1C is not at goal. Sulfonylureas are avoided because of hypoglycemia risk during long, hot shifts with irregular meals.
Blood pressure. Lifestyle changes and diabetes treatment may lower blood pressure, but at 146/92 medication is reasonable. Amlodipine 5 mg once daily is chosen over an ACE inhibitor or diuretic for the harvest season, because diuretics and, in the setting of dehydration, ACE inhibitors can increase the risk of kidney injury in workers exposed to heat. An ACE inhibitor will be reconsidered after harvest, especially if albuminuria appears.
Monitoring. A glucose meter with strips costs about $20 to $30 a month without insurance, which would compete with food and rent. Instead of daily testing, the plan uses A1C every three months at the mobile unit, which the health center provides on a sliding fee, and a meter only if symptoms of low or very high glucose occur.
Heat Safety as Part of Diabetes Care
Heat and dehydration are real risks for this patient, and diabetes adds to them. Drinking water regularly, taking rest breaks in the shade and adjusting work hours are the main protective factors identified in research on farmworker heat illness (El Khayat et al., 2022). The plan: carry a gallon container of water to the field; drink a cup every 15 to 20 minutes during work rather than waiting for thirst; take shade breaks; limit sugary drinks, which raise glucose and do not hydrate well; and recognize warning signs of heat illness, such as headache, dizziness, confusion, cramps and very dark urine. His crew supervisor will be given, with his permission, a one-page Spanish heat safety sheet from the health center.
Education in His Language
Education will be given through a telephone Mixteco interpreter, not in Spanish alone, because health disparities among migrant workers are driven in part by language and cultural barriers (Moyce & Schenker, 2018). Teaching uses pictures of plates, pill bottles and the sun rather than written text, and teach-back is used after each point: he explains in his own words when to take the pill, what to drink in the field and when to come to the clinic. His wife, who reads some Spanish, is invited to the next visit with his consent.
Food and Activity
Advice builds on what the family already eats: corn tortillas and beans are kept; portions of rice and sweet bread are reduced; sweetened sodas and juices are replaced with water or unsweetened agua fresca. His work is already very physical, so no extra exercise is recommended during harvest; in winter, a daily walk after dinner is suggested.
Follow-Up and Continuity
Follow-up at the mobile unit in two weeks, on an evening visit, to check tolerance of metformin, blood pressure and signs of heat illness; then every month during harvest and every three months after. He is given a wallet card with his diagnoses, medications and the clinic's phone number, in Spanish and with pictures, so that care can continue if he works in another county. A community health worker who speaks Mixteco will call him the week after this visit.
Referral Criteria and Return Precautions
Refer for a dilated eye examination through the health center's sliding-fee arrangement within three months, sooner if blurred vision persists after glucose improves. Refer to the emergency department for confusion, fainting, vomiting with inability to keep fluids down, or a glucose above 400 mg/dL if a meter is used. Return to clinic for persistent diarrhea from metformin, leg swelling on amlodipine, or any foot sore that does not heal within a week.
References
American Diabetes Association Professional Practice Committee. (2025). 9. Pharmacologic approaches to glycemic treatment: Standards of care in diabetes, 2025. Diabetes Care, 48(Suppl. 1), S181-S206. https://doi.org/10.2337/dc25-S009
El Khayat, M., Halwani, D. A., Hneiny, L., Alameddine, I., Haidar, M. A., & Habib, R. R. (2022). Impacts of climate change and heat stress on farmworkers' health: A scoping review. Frontiers in Public Health, 10, 782811. https://doi.org/10.3389/fpubh.2022.782811
Moyce, S. C., & Schenker, M. (2018). Migrant workers and their occupational health and safety. Annual Review of Public Health, 39, 351-365. https://doi.org/10.1146/annurev-publhealth-040617-013714
What the D120 Task 2 instructions ask
The second D120 task asks you to apply your population analysis to an individual patient's care. Most versions ask you to describe the patient and circumstances, plan clinical management based on guidelines, adapt the plan to the population's barriers, address education in the patient's language and culture, and plan follow-up and referral. The patient should come from the population analyzed in Task 1. Evaluators look for guideline-based care adapted to real constraints, such as work hours, language, cost and housing, rather than an ideal plan the patient cannot follow. Each adaptation should be explained with evidence or with the barriers identified earlier.
How this D120 Task 2 example is built
The plan opens with the patient's situation, including when and where he can be seen. Clinical management follows current diabetes standards and then tests each recommendation against his circumstances, such as choosing a medication with low cost and low hypoglycemia risk in the heat. A separate section treats heat safety as part of diabetes care. Education uses an interpreter in his first language and teach-back. Food advice keeps familiar foods and changes portions and drinks. Follow-up is scheduled at the mobile unit in the evening, and referral criteria use resources he can access. Every adaptation links back to a barrier in the Task 1 analysis. The plan reads as something a mobile unit could carry out on its next evening visit.
Where the D120 Task 2 rubric puts the marks
D120 Task 2 aspects are rated competent, approaching competence or not evident. A clinical management aspect checks that care follows current guidelines. An adaptation aspect rewards changes that fit the patient's circumstances and the population's barriers. An education aspect wants teaching in the patient's language with methods to confirm understanding. Follow-up and referral aspects ask for realistic timing and access. Evaluators check that the plan draws on the Task 1 analysis and that clinical choices are supported by current standards of care. Evaluators notice when each adaptation names the barrier it answers, such as evening follow-up for a worker who cannot leave the field during the day. Plans that keep guideline targets while changing how care is delivered show the balance the course expects.
D120 Task 2 help: what sends it back
Applied care plans come back most often when they describe ideal care the patient cannot access. Test each recommendation against his work, language, cost and location. Second, adaptations are not explained. Link each to a barrier and a source. Third, education is delivered in a second language without comment. Plan for interpretation in the patient's first language. Fourth, follow-up is scheduled during work hours. Fit it to when the patient can come. Finally, keep the patient connected to the population analysis, since the task is meant to show how population knowledge changes individual care. Name the interpreter service you will use.
Get a D120 Task 2 example written to your instructions
Send the D120 Task 2 instructions and the rubric aspects your course of study lists, along with the population and any scenario you were given. We write a custom example to those aspects, with the barriers actually changing the plan rather than sitting beside it, and return it in 24-48h. The first custom sample is free.
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D120 Task 2 questions, answered
How is the applied task different from the population analysis?
The analysis works at group level with surveillance data and stratification. This one puts a single composite patient in front of you and asks what care survives contact with their circumstances. Population statistics belong in a sentence or two of context here, and the rest of the length goes to a plan with substitutions, resources and a realistic follow-up arrangement.
Should the barriers be realistic or extreme?
Realistic and specific beats extreme. Two or three concrete obstacles, such as no vehicle, hourly work with no paid leave and a copayment the patient cannot cover, give the plan enough to reason around without turning the case into a catalogue of hardship. Every barrier you name should visibly change at least one element of the plan.
Can I use a patient from my clinical site for this?
Check your instructions, and strip every identifier if real cases are permitted. A constructed patient is usually the better choice because you can install the exact barriers the task wants examined. Documentation of an actual patient encounter is your responsibility and is never drafted for you, and nothing here is guidance for anyone's care.
How is the D120 applied task different from the population analysis?
Task 1 analyzes a population; Task 2 applies that analysis to one patient's plan. The sample carries farmworker barriers into diabetes care for one man during harvest.
Where can I find a free D120 Task 2 sample paper?
The mobile-unit diabetes plan appears in full above, annotated. Share your D120 task and patient, and a first tailored care plan will be written for you free.