| Course | DNP 643 Developmentally Based Care of the Well Child |
|---|---|
| Module | Module 2 |
| Paper type | Case study response with peer reply |
| Length | About 516 words |
| Format | Discussion post with APA 7 citations |
| School | Arizona State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for DNP 643 Module 2
Case Study 2: She Always Looks to the Right
She Always Looks to the Right: Positional Plagiocephaly, Torticollis and Safe Sleep at a 4-Month Well Visit
The Case
L., a 4-month-old girl, comes for her well visit. Her parents are worried about a flat spot on the right back of her head that they noticed at 2 months. She sleeps on her back in a crib, spends much of the day in a car seat carrier and bouncer and "hates tummy time." Her mother says she "always looks to the right." Her pregnancy was uncomplicated and she arrived at full term. Growth and development are on track.
Case Study Response
Assessment
Viewed from above, L.'s head shows right occipital flattening with the right ear displaced forward and slight right frontal bossing, giving the head a parallelogram shape. This pattern is typical of positional (deformational) plagiocephaly. Craniosynostosis of the lambdoid suture, which is rare, produces a trapezoid shape with the ear pulled backward and a ridge along the suture (Laughlin et al., 2011). Her neck shows reduced rotation to the left and a firm area in the right sternocleidomastoid, consistent with congenital muscular torticollis, which commonly travels with positional plagiocephaly because the infant keeps resting on the same spot.
Differential
Positional plagiocephaly with right torticollis is the working diagnosis. Craniosynostosis is unlikely from the shape but would be considered if the head shape worsens despite treatment or a ridge is felt. Ocular torticollis from a vision problem and cervical spine anomalies are less common causes of a head tilt to rule out with the eye examination and history.
Plan
I would refer L. to pediatric physical therapy for torticollis, since early stretching and strengthening improve neck range of motion and help the head shape (Kaplan et al., 2018). At home, parents should reposition her: alternate the end of the crib where her head lies so that room activity draws her gaze left, offer toys and feeding from the left side and increase supervised tummy time while awake. Time in car seats and bouncers outside of travel should be limited. Most positional plagiocephaly improves with these measures by 6 months. A cranial orthosis may be discussed if moderate to severe asymmetry persists despite repositioning and therapy, ideally between about 4 and 6 months, with the parents told that evidence on its added benefit is mixed (Laughlin et al., 2011).
Anticipatory Guidance
The most important message is that she should keep sleeping on her back. The Back to Sleep campaign reduced sudden infant death (Moon et al., 2022), and the rise in positional plagiocephaly that followed is managed by changes while she is awake, not by changing her sleep position. I would recheck her head shape and neck range at the 6-month visit.
Reply to a Classmate (On Tummy Time)
Andre, you asked what to tell parents whose baby cries during tummy time. I suggest starting with short sessions several times a day, on a parent's chest or across the lap, and building up as neck strength improves. Getting down to her eye level with a toy helps. Did your plan set a daily goal parents could track?
References
Kaplan, S. L., Coulter, C., & Sargent, B. (2018). Physical therapy management of congenital muscular torticollis: A 2018 evidence-based clinical practice guideline from the APTA Academy of Pediatric Physical Therapy. Pediatric Physical Therapy, 30(4), 240-290. https://doi.org/10.1097/PEP.0000000000000544
Laughlin, J., Luerssen, T. G., Dias, M. S., & Committee on Practice and Ambulatory Medicine, Section on Neurological Surgery. (2011). Prevention and management of positional skull deformities in infants. Pediatrics, 128(6), 1236-1241. https://doi.org/10.1542/peds.2011-2220
Moon, R. Y., Carlin, R. F., Hand, I., & Task Force on Sudden Infant Death Syndrome and the Committee on Fetus and Newborn. (2022). Sleep-related infant deaths: Updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics, 150(1), Article e2022057990. https://doi.org/10.1542/peds.2022-057990
DNP 643 Module 2 instructions, in plain terms
In Week 5 the course turns to infants from 1 to 12 months, and Case Study 2 arrives with the discussion board and the second quiz. As in Week 4, the case opens Sunday, your referenced APA response is due Wednesday and a classmate needs your reply before Friday closes the week. Infant cases at well visits often begin with a parent's worry, such as head shape, feeding or sleep, and the strongest responses treat the worry seriously, examine for the cause behind it and keep safety advice intact. Check the Canvas questions for the case, because each one usually maps to a part of the visit: assessment, differential, plan and guidance. The infant cases also reward attention to development, so note milestones even when the concern is physical.
Inside the DNP 643 Module 2 example
Like a completed case study post, the sample summarizes the case, then answers under four headings. The assessment describes the head shape from above and explains how it differs from lambdoid craniosynostosis, and it identifies torticollis on the neck examination. A brief differential names what else could cause a head tilt and when craniosynostosis would come back into question. The plan covers physical therapy, specific repositioning steps, limits on time in seats and the place of a helmet with an honest note on the evidence. Anticipatory guidance protects back sleeping and sets a recheck. A reply addresses a classmate's practical problem, a baby who resists tummy time, with steps parents can use.
Reading the DNP 643 Module 2 grading rubric
Ten points are available for the second case. Faculty generally look for a precise physical description, a differential that includes the serious alternative and the reason it is unlikely, home measures parents can follow, referrals with a time frame and anticipatory guidance that suits the infant's age. References should be recent and in APA format. Responses lose credit when they recommend something that conflicts with safe sleep guidance, when the plan says to monitor without saying for what or until when and when the reply to a classmate adds nothing. The five cases are worth 30% of the grade together, so each one is worth doing fully.
DNP 643 Module 2 help from the desk
Do not let the head shape distract from the neck. Positional flattening often has torticollis behind it, so describe the range of motion. Never solve a flat spot by changing sleep position; repositioning belongs to awake time. Say how you would tell flattening from craniosynostosis on examination. Present helmets honestly, including the uncertain evidence. Use clinical reports and therapy guidelines rather than product sites, and keep the infant de-identified. Make your reply practical, such as how to coach tummy time. For help planning which findings to address first, send the desk the case and its questions as posted in Canvas. Describe what you measured, such as the degree of neck rotation, so that a recheck at 6 months can show change.
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 643 Module 2 questions, answered
Where can I find a free DNP 643 Module 2 sample paper?
The DNP 643 Module 2 sample above is a full infant case study response on positional plagiocephaly and torticollis at a 4-month visit, with a peer reply.
How do you tell positional plagiocephaly from craniosynostosis?
Positional flattening gives a parallelogram head with the ear pushed forward; lambdoid craniosynostosis gives a trapezoid shape with the ear pulled back and often a palpable ridge.
Should a baby with a flat head sleep on her side?
No. Infants should sleep on their backs; head shape is treated with repositioning, tummy time and therapy while the baby is awake.
When is a helmet considered for plagiocephaly?
Usually for moderate to severe asymmetry that persists despite repositioning and therapy, often discussed between about 4 and 6 months of age.
What does Week 5 of DNP 643 cover?
Care of the infant from 1 to 12 months, with a discussion board, Case Study 2 and Quiz 2 due that week.