| Course | DNP 619 Principles of Pediatric Acute Care II |
|---|---|
| Module | Module 2 |
| Paper type | Pediatric acute care case study |
| Length | About 626 words, 5 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | DNP |
| Updated | October 2026 |
Free sample paper for DNP 619 Module 2
Six Hours After the Bottle: A Pediatric Acute Care Case Study of Intentional Acetaminophen Ingestion
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
DNP 619: Principles of Pediatric Acute Care II
Instructor Name
Month Day, Year
Six Hours After the Bottle: A Pediatric Acute Care Case Study of Intentional Acetaminophen Ingestion
Summary
K.T., a 15-year-old girl, tells her mother she took "most of a bottle" of 500 mg acetaminophen tablets about six hours ago after a breakup. She has nausea and one episode of vomiting. Vital signs: heart rate 104, blood pressure 112/68, temperature normal, SpO2 99%. She is alert, tearful and cooperative. Weight 55 kg. If the bottle held 50 tablets and she took 40, she ingested about 20 g, or roughly 364 mg/kg, far above the toxic threshold.
Missing information: exact time and amount, coingestants (especially opioids, anticholinergics or other drugs in the home), prior ingestions or self-harm, alcohol use, pregnancy status, and baseline liver disease.
Problem List
1. Health maintenance: due for adolescent well visit; HPV series incomplete; no recent depression screening.
2. Intentional acetaminophen ingestion with potentially toxic dose.
3. Suicide attempt; risk of further self-harm.
4. Nausea and vomiting.
5. Psychosocial stressor: relationship loss; school and family supports to be assessed.
Differential Diagnosis
1. Acetaminophen poisoning, acute ingestion, at risk for hepatotoxicity. Most likely given history, timing and dose.
2. Mixed ingestion with a coingestant such as an opioid or diphenhydramine. Must be excluded because coingestion changes management and the consensus guideline addresses it specifically (Dart et al., 2023).
3. Gastroenteritis or pregnancy-related nausea. Less likely given the history but relevant to symptoms.
4. Salicylate ingestion, if the bottle was misidentified. Checked routinely because it is treatable and dangerous.
Plan of Care
Diagnostics: Serum acetaminophen level at 4 hours or later after ingestion, which in her case is now; liver enzymes, INR, bilirubin, creatinine, glucose, salicylate and ethanol levels, pregnancy test, and an electrocardiogram if coingestion is suspected. The 2023 consensus guideline defines acute ingestion as presentation 4 to 24 hours after the overdose began and uses a revised Rumack-Matthew nomogram to decide treatment (Dart et al., 2023).
Medications: Start intravenous acetylcysteine promptly if the level is at or above the treatment line, or without waiting for the level if results will be delayed beyond 8 hours from ingestion. The guideline also identifies a high-risk ingestion line for very large doses, which may change acetylcysteine dosing, and gives criteria for when treatment can stop (Dart et al., 2023). Treat nausea with ondansetron, since vomiting can delay oral intake and complicate monitoring, and recheck liver tests and the INR at the end of the acetylcysteine course. Activated charcoal is generally not helpful this late after a single acetaminophen ingestion unless a coingestant is suspected.
CAM: None indicated acutely; avoid herbal products with liver toxicity during recovery.
Consults: Regional poison center or medical toxicology, ideally contacted at arrival, psychiatry or the hospital's adolescent mental health team, and social work. Hepatology if liver injury develops.
Safety: Continuous observation, removal of medications and sharps from the room, and a structured suicide risk assessment once she is medically able; national guidance supports screening adolescents for depression and suicide risk (US Preventive Services Task Force, 2022).
Patient and caregiver education: Explain acetylcysteine and why it works best when started early. Teach the family to lock up all medications at home, including over-the-counter drugs, before discharge.
Strategies to build trust: Speak with K.T. alone, explain confidentiality and its limits as pediatric consent guidance describes (Katz et al., 2016), acknowledge her pain without judgment, and involve her in decisions about who learns what. Before discharge, complete a safety plan with her and her parents, arrange outpatient mental health follow-up within a week, and confirm that liver tests have normalized. Her school counselor can be included with her permission, which helps her return to class with support rather than secrecy.
References to Practice
Consensus guidance standardizes what had been widely varied care (Dart et al., 2023).
References
Dart, R. C., Mullins, M. E., Matoushek, T., Ruha, A.-M., Burns, M. M., Simone, K., Beuhler, M. C., Heard, K. J., Mazer-Amirshahi, M., Stork, C. M., Varney, S. M., Funk, A. R., Cantrell, L. F., Cole, J. B., Banner, W., Stolbach, A. I., Hendrickson, R. G., Lucyk, S. N., Sivilotti, M. L. A., ... Rumack, B. H. (2023). Management of acetaminophen poisoning in the US and Canada: A consensus statement. JAMA Network Open, 6(8), e2327739. https://doi.org/10.1001/jamanetworkopen.2023.27739
Katz, A. L., Webb, S. A., & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Pediatrics, 138(2), e20161485. https://doi.org/10.1542/peds.2016-1485
US Preventive Services Task Force. (2022). Screening for depression and suicide risk in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA, 328(15), 1534-1542. https://doi.org/10.1001/jama.2022.16946
What the DNP 619 Module 2 instructions ask for
The posted syllabus lists two faculty-assigned case studies, each worth 20 points, submitted in Canvas in essay format; Case Study 1 is due in Week 5, Toxicological Exposures. Each case should include a summary of key issues and data with missing information named, a problem list that begins with health maintenance, three or four differential diagnoses with brief rationale, an interprofessional plan of care with medications, complementary therapies, consults, patient and caregiver education and strategies to build trust, and peer-reviewed references in APA, with lay sources only for teaching. More detail is in the rubric. Read the week's toxicology chapter and the current guideline for your ingestion before drafting, since the plan depends on precise timing and thresholds.
How the DNP 619 Module 2 example is put together
The sample follows the syllabus's required headings in order. The summary includes a dose estimate in mg/kg and lists missing information that would change management. The problem list begins with health maintenance, as required. Four differentials are ranked with reasons. The plan addresses diagnostics, medications, complementary therapy, consults, safety, education and trust, and applies the 2023 consensus guideline to timing and acetylcysteine. Mental health and confidentiality receive as much attention as the toxicology. A dose calculation per kilogram shows why the ingestion is dangerous, and each plan item states timing as well as the drug. Mental health care sits beside the antidote. Missing information is listed in the summary, so readers see what would change the plan if it were known.
DNP 619 Module 2 rubric: what earns full marks
Case studies are usually graded on a complete summary with missing data identified, a problem list starting with health maintenance, reasonable differentials with rationale, a thorough interprofessional plan that includes education and trust-building, and current peer-reviewed references. Faculty look for plans that are specific about timing and drugs and that address the whole patient, including psychosocial risks. Applying a current guideline, rather than older rules of thumb, shows evidence-based practice. Plans that name consultants and the reasons for consulting them demonstrate interprofessional thinking, which the syllabus requires. Clear headings that match the required sections help graders. Including follow-up after discharge shows complete care.
DNP 619 Module 2 help: mistakes that cost marks
Students often focus only on the antidote and forget the suicide attempt. Address safety and mental health in the plan. Another common gap is skipping health maintenance at the top of the problem list. Calculate the dose per kilogram. Name the information you are missing. Use current guidelines for acetaminophen management. For feedback on a pediatric acute care case before submitting, share it with the desk. Check the time since ingestion before interpreting any level, since the nomogram applies only within a set window. Keep the case composite and respectful. Name every consultant and the reason for calling them.
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 619 Module 2 questions, answered
Where can I find a free DNP 619 Module 2 sample paper?
The toxicology case study is above in full: an intentional acetaminophen ingestion in a 15-year-old, with summary, problem list, differentials and an interprofessional plan using current guidance, plus references.
What sections does a DNP 619 case study need?
A summary with missing information, a problem list starting with health maintenance, three or four differentials, an interprofessional plan and APA references.
How much are DNP 619 case studies worth?
The syllabus lists two case studies at 20 points each.
When is acetylcysteine started for acetaminophen overdose?
When the serum level is at or above the nomogram treatment line, or empirically if results will be delayed after a potentially toxic ingestion.
Why include trust-building in a pediatric plan of care?
Adolescents, especially after self-harm, need confidentiality and respect to engage in care and safety planning.