DNP 645 Module 2 Mouth Case Study: Gingivostomatitis Example

Course	DNP 645 Management of Common Problems in Pediatric Primary Care
Module	Module 2
Paper type	Hosted case study thread (host case, differential table and management plan)
Length	About 509 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 645 Module 2

Case Study 2: A Toddler Who Will Not Drink

A Toddler Who Will Not Drink: A Hosted Case Study on Primary Herpetic Gingivostomatitis and Keeping a 2-Year-Old Hydrated

Host Post: The Case

E., a 2-year-old girl, has had fever to 103 F for two days, drooling and fussiness, and has refused most food and drink since yesterday. Her gums are red, swollen and bleed easily, and there are clusters of small, painful ulcers on the gums, tongue and inner lips, with a few vesicles on the skin around her mouth. She has tender anterior cervical nodes. She has had two wet diapers in the past 24 hours.

Subjective Questions and Host Answers

Any sores on the hands, feet or buttocks? No. Contact with anyone with cold sores? Her father had a cold sore last week. New medications before the rash? None. Recurrent mouth ulcers before? No. Eye redness or eye pain? No. Last urine output and tears? Two wet diapers, fewer tears.

Differential Diagnosis Table

Possible diagnosis	What fits	What does not fit
Primary herpetic gingivostomatitis	Fever, swollen bleeding gums, anterior oral ulcers, perioral vesicles, cold sore contact	None
Hand, foot and mouth disease	Fever, oral ulcers in a toddler	Hand, foot or buttock lesions; gingivitis is not typical
Herpangina	Fever, oral ulcers	Ulcers would sit on the soft palate and tonsillar pillars, without gingivitis
Aphthous ulcers	Painful oral ulcers	Fever, gingivitis, clusters, vesicles on the skin
Stevens-Johnson syndrome	Painful mucosal ulcers	New drug, skin target lesions, eye involvement

What this page is doingThe table lets the location of the ulcers and the swollen gums do the diagnostic work, which is the key distinction between herpes and the enteroviral illnesses in a toddler.

Management Plan

Most probable diagnosis: primary herpetic gingivostomatitis (HSV-1), with mild dehydration.

Testing: The diagnosis is clinical, resting on the anterior ulcers and gingivitis that set it apart from enteroviral illness (Kliegman et al., 2024). A swab of a vesicle for HSV PCR can confirm it when the picture is unclear.

Treatment: The priority is fluids. Offer small, frequent amounts of cold liquids and popsicles; avoid acidic juices. Give acetaminophen or ibuprofen on a schedule, timed before drinking. Oral acyclovir started within the first 72 hours of symptoms shortens the illness in young children, so E., at day two, is a candidate: 15 mg/kg five times a day for 7 days (Kimberlin et al., 2024). Avoid topical viscous lidocaine in a toddler because of the risk of toxicity if swallowed.

Supporting article: When children with gingivostomatitis were randomized to acyclovir or placebo under double-blind conditions, acyclovir started within three days shortened oral lesions, fever, eating and drinking difficulties and viral shedding (Amir et al., 1997).

Anticipatory guidance: Keep E. home from child care until she is fever-free and the lesions have crusted and she can manage her saliva. Wash hands after touching her mouth; do not share cups or utensils; adults with cold sores should not kiss children. Watch for spread to the eyes or fingers.

Family websites: HealthyChildren.org on cold sores and on dehydration in young children.

Follow-up: Phone check in 24 hours on fluid intake and diapers. Return the same day for no urine in 8 hours, lethargy, eye pain or redness, or inability to drink, which would prompt admission for intravenous fluids (Kimberlin et al., 2024).

What this page is doingThe plan makes hydration the first priority and turns it into numbers parents can track, then justifies acyclovir with a trial and the time window, which is what separates a usable plan from a description of the illness.

References

Amir, J., Harel, L., Smetana, Z., & Varsano, I. (1997). Treatment of herpes simplex gingivostomatitis with aciclovir in children: A randomised double blind placebo controlled study. BMJ, 314(7097), 1800-1803. https://doi.org/10.1136/bmj.314.7097.1800

Kimberlin, D. W., Banerjee, R., Barnett, E. D., Lynfield, R., & Sawyer, M. H. (Eds.). (2024). Red Book: 2024-2027 report of the Committee on Infectious Diseases (33rd ed.). American Academy of Pediatrics.

Kliegman, R. M., St. Geme, J. W., Blum, N. J., Tasker, R. C., Wilson, K. M., Schuh, A. M., & Mack, C. L. (Eds.). (2024). Nelson textbook of pediatrics (22nd ed.). Elsevier.

Reading the DNP 645 Module 2 assignment instructions

Week 5 in DNP 645 moves to the head, mouth, neck and throat, and its hosted case runs from Sunday to Saturday. Roles are assigned by the hosting pair when the case appears: some classmates ask for the history that is missing, a pair then posts the differential as a table of five possibilities with what each does and does not explain, and a final pair writes the plan with tests, treatment, an attached article of high evidence level, guidance for the family, websites and the follow-up schedule. Discussion carries on until the group settles on a confirmed diagnosis. Oral lesion cases in young children often turn on hydration and lesion location, so plan to address both.

Inside the DNP 645 Module 2 example

The sample shows the full arc of a hosted case. The host post describes the toddler's fever, gums, ulcers and urine output. The subjective section shows the questions that separate the diagnoses, such as the location of other lesions, cold sore contact and new medications, with the host's answers. The differential table compares five diagnoses, marking which details are present and absent and using ulcer location and gingivitis as the deciding features. The management plan states the most probable diagnosis, puts hydration first with practical steps, gives acyclovir with dose, duration and timing, supports it with a randomized trial, covers infection control and child care, lists family websites and sets follow-up with clear return precautions.

DNP 645 Module 2 rubric: what earns full marks

Ten points ride on Case Study 2. When faculty read a mouth or throat case, they tend to credit questions about fluid intake, urine output and sick contacts, a differential that uses where the lesions sit to separate viral illnesses, and a plan that puts the child's safety first with clear numbers parents can act on. Medication advice should include dose, frequency, duration and the time window in which a drug helps. Safety errors, such as recommending numbing agents that young children can swallow, cost points. Because the case studies together count for 30% of the grade, missing a week's role is costly, so confirm your assignment with the host on Sunday.

DNP 645 Module 2 help: mistakes that cost marks

A frequent slip in toddler mouth cases is listing every viral exanthem without saying which feature rules each out. Use lesion location and the presence or absence of gum involvement. Another is a hydration plan that says only to push fluids; give amounts, types of drinks and the urine output that should prompt a return visit. State when an antiviral helps and when it is too late to matter. Keep return precautions concrete. Avoid adult remedies that are unsafe in small children. When you attach a supporting article, choose one that tested the treatment you recommend. The desk can review your draft if you share the host's case and the role you were given.

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.

More DNP 645 and Doctor of Nursing Practice sample papers

DNP 645 Module 2 questions, answered

Where can I find a free DNP 645 Module 2 sample paper?

The DNP 645 Module 2 sample here is a full hosted case study on herpetic gingivostomatitis in a 2-year-old, with the differential table and a hydration-first plan.

How do you tell herpetic gingivostomatitis from herpangina?

Herpes causes swollen, bleeding gums and ulcers at the front of the mouth; herpangina causes ulcers at the back, on the soft palate and tonsillar pillars, without gingivitis.

Does acyclovir help children with gingivostomatitis?

A randomized trial found that acyclovir started within three days shortened lesions, fever and feeding difficulty in young children.

When does a child with mouth sores need to be seen urgently?

When there is no urine for about 8 hours, lethargy, inability to drink, or eye pain or redness suggesting the virus has spread to the eye.

What does Week 5 of DNP 645 cover?

Head, mouth, neck and throat disorders, with Case Study 2 running all week and Quiz 5 due.

DNP 645 Module 2 Case Study 2: Head, Mouth, Neck and Throat Disorders (Herpetic Gingivostomatitis) Example