DNP 606 Module 6 Case Study 3: Pediatric Status Epilepticus Example

Reviewed by Ingrid Vasterling, MSN, RN Arizona State University Updated October 2026

This DNP 606 Module 6 sample is case study 3 in Principles of Pediatric Acute Care I, from ASU's Doctor of Nursing Practice pediatric acute care specialty. Three faculty cases are graded in ASU DNP 606, and this is the last; like the others it needs a summary, ranked problems, a ranked differential and a plan for the whole team. This composite case follows the neurology week: a 7-year-old boy with epilepsy who arrives still seizing 12 minutes after onset. The answer lists missing data, four differentials and a timed plan: a benzodiazepine first, then a second-line drug chosen from levetiracetam, fosphenytoin or valproate, with airway support, glucose checks, a neurology consult and a seizure action plan for his family.

CourseDNP 606 Principles of Pediatric Acute Care I
ModuleModule 6
Paper typePediatric acute care case study
LengthAbout 523 words, 4 pages
FormatAPA 7 student paper
SchoolArizona State University
ProgramDoctor of Nursing Practice
UpdatedOctober 2026

Free sample paper for DNP 606 Module 6

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Stopping the Seizure: A Pediatric Acute Care Case Study of Convulsive Status Epilepticus in a 7-Year-Old

Student Name

Edson College of Nursing and Health Innovation, Arizona State University

DNP 606: Principles of Pediatric Acute Care I

Instructor Name

Month Day, Year

What this page is doingThe title names the goal that drives the whole plan, ending the seizure quickly, along with the diagnosis and age.
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Stopping the Seizure: A Pediatric Acute Care Case Study of Convulsive Status Epilepticus in a 7-Year-Old

Case

A 7-year-old boy with epilepsy, treated with levetiracetam, has a generalized tonic-clonic seizure at school. EMS gives one dose of intramuscular midazolam en route. On arrival 12 minutes after onset, he is still seizing, with a heart rate of 150, oxygen saturation of 91% on a non-rebreather and a temperature of 37.4 C. His mother reports he has missed doses this week during a family move.

1. Summary

Key issues. This is convulsive status epilepticus that has continued despite one benzodiazepine dose, in a child with known epilepsy and likely missed medication. Each minute of continued seizure activity lowers the chance of response to treatment, so the plan is time-driven. National guidance describes a benzodiazepine as initial therapy, followed by a second-line drug if seizures continue (Glauser et al., 2016).

Missing information. Weight, point-of-care glucose, electrolytes including sodium and calcium, a levetiracetam level if available, recent illness or head injury, ingestion possibilities, allergies and the time of each medication dose.

What this page is doingThe summary states why the case is urgent and what has already been given, which tells the reader exactly where in the treatment pathway the plan begins.
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2. Problem List

1. Health maintenance: immunizations to confirm; seizure action plan at school to review.

2. Convulsive status epilepticus, ongoing after one benzodiazepine dose.

3. Hypoxemia during the seizure.

4. Probable missed antiseizure medication during a family move.

5. Family and school knowledge gaps about rescue medication.

3. Differential Diagnosis

1. Breakthrough status epilepticus from missed doses: most likely given the history.

2. Provoking cause, such as hypoglycemia, hyponatremia or infection: checked with glucose, electrolytes and temperature.

3. Toxic ingestion during the move, such as an adult's medication: a toxicology screen and careful history.

4. Central nervous system infection or injury: considered if fever, meningeal signs or a head injury history emerge, prompting imaging or lumbar puncture.

4. Plan of Care

Immediate steps. Position him safely, support the airway with oxygen and suction, check glucose and correct if low, and place intravenous access.

Benzodiazepine. Give a second benzodiazepine dose, since he has received only one, as the guideline's initial phase allows (Glauser et al., 2016).

Second-line therapy. If the seizure continues, give levetiracetam, fosphenytoin or valproate. In the ESETT trial, children with established status epilepticus responded similarly to all three, with seizure cessation and improved responsiveness in about half of children for each drug (Chamberlain et al., 2020). Because he already takes levetiracetam and may have a low level, levetiracetam is a reasonable choice; valproate is avoided if a metabolic disorder is suspected.

If seizures persist. Prepare for intubation and a continuous infusion in the PICU, with continuous EEG monitoring for nonconvulsive seizures. The adult and pediatric ESETT results confirmed that about half of patients need more than the second-line drug (Kapur et al., 2019).

Consults. Neurology; PICU if refractory; pharmacy for levels and dosing; social work if the move has disrupted access to medication.

Complementary approaches. None replace antiseizure medication; once stable, sleep regularity and stress reduction support seizure control.

Education and trust. Explain to his mother what happened without blame for missed doses, review the home rescue medication and when to use it, update the school seizure action plan and arrange neurology follow-up.

What this page is doingThe plan follows the guideline's timed phases and uses a pediatric trial to justify the second-line choice for this child, which shows the reader how evidence and the patient's history combine in one decision.
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References

Chamberlain, J. M., Kapur, J., Shinnar, S., Elm, J., Holsti, M., Babcock, L., Rogers, A., Barsan, W., Cloyd, J., Lowenstein, D., Bleck, T. P., Conwit, R., Meinzer, C., Cock, H., Fountain, N. B., Underwood, E., Connor, J. T., & Silbergleit, R. (2020). Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): A double-blind, responsive-adaptive, randomised controlled trial. The Lancet, 395(10231), 1217-1224. https://doi.org/10.1016/S0140-6736(20)30611-5

Glauser, T., Shinnar, S., Gloss, D., Alldredge, B., Arya, R., Bainbridge, J., Bare, M., Bleck, T., Dodson, W. E., Garrity, L., Jagoda, A., Lowenstein, D., Pellock, J., Riviello, J., Sloan, E., & Treiman, D. M. (2016). Evidence-based guideline: Treatment of convulsive status epilepticus in children and adults: Report of the Guideline Committee of the American Epilepsy Society. Epilepsy Currents, 16(1), 48-61. https://doi.org/10.5698/1535-7597-16.1.48

Kapur, J., Elm, J., Chamberlain, J. M., Barsan, W., Cloyd, J., Lowenstein, D., Shinnar, S., Conwit, R., Meinzer, C., Cock, H., Fountain, N., Connor, J. T., & Silbergleit, R. (2019). Randomized trial of three anticonvulsant medications for status epilepticus. New England Journal of Medicine, 381(22), 2103-2113. https://doi.org/10.1056/NEJMoa1905795

DNP 606 Module 6 instructions, in plain terms

Case study 3 follows the neurology and renal weeks of the posted syllabus, which cover seizures, neuromuscular and neurocutaneous disorders, kidney injury and hypertension. It closes the set of three faculty cases, each scored out of 20 and entered as a Canvas essay quiz before the deadline. The format matches the first two cases, from the summary and the health-maintenance-first problem list through the short differential, the interprofessional plan and the reference list. Time-sensitive problems benefit from a plan organized by phase. Expect a seizure, kidney or blood pressure problem, since those topics fill the weeks just before the due date.

How this DNP 606 Module 6 example is built

After a short restatement of the composite case, the answer works through all five required parts. Its summary explains why the seizure is an emergency and where the child is in the treatment pathway. The problem list begins with health maintenance and includes the likely cause. Four differentials cover breakthrough seizures, provoking metabolic causes, ingestion and infection or injury, each with a test. The plan is organized by phase: immediate support, a second benzodiazepine, second-line choice justified by a pediatric randomized trial and escalation, followed by consults, a note on complementary approaches and family teaching. Three sources support it: the national guideline and two reports from the ESETT trial. The second-line choice is explained in terms of this child's existing medication and likely low drug level, which shows tailoring rather than a memorized algorithm. Family teaching covers home rescue medication and the school plan.

Reading the DNP 606 Module 6 grading rubric

Faculty are likely to look for recognition of status epilepticus and its urgency, a prioritized problem list starting with health maintenance, differentials that include provoking causes, a plan that follows the guideline's timed phases, an evidence-based second-line choice tailored to the patient, appropriate consults and specific family education, with APA references. The strongest answers say why one second-line drug fits this child. Mentioning glucose and electrolyte checks shows attention to reversible causes. A school and home rescue plan meets the education and trust elements of the format. Mentioning continuous EEG monitoring in refractory cases is also a plus.

DNP 606 Module 6 help with common mistakes

A typical weakness is a plan that lists drugs without a time sequence. Organize by phase and state what triggers the next step. Another is forgetting reversible causes such as low glucose. Explain why you chose a particular second-line drug. For help with the third case, paste the faculty's case and your draft into a message to the desk. Confirm weight-based doses in a pediatric reference. Include follow-up with neurology and the school plan. State what you would do if the second-line drug fails, since faculty often probe the next step. Note the time each dose was given. Add when the child should see neurology again and what the school nurse needs to know.

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 Arizona State 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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DNP 606 Module 6 questions, answered

Where can I find a free DNP 606 Module 6 sample paper?

A finished DNP 606 case study 3 sample on pediatric status epilepticus, with a timed plan based on the ESETT trial, is posted here.

What is first-line treatment for status epilepticus in children?

A benzodiazepine, which may be repeated once, followed by a second-line drug if seizures continue.

Which second-line drug works best for status epilepticus in children?

The ESETT trial found levetiracetam, fosphenytoin and valproate worked similarly, each stopping seizures in about half of children.

What should be checked in a child with prolonged seizures?

Glucose, electrolytes, medication levels, signs of infection or injury and possible ingestions.

When is case study 3 due in DNP 606?

The posted syllabus places it after the neurology and renal weeks.