| Course | DNP 645 Management of Common Problems in Pediatric Primary Care |
|---|---|
| Module | Module 3 |
| Paper type | Hosted case study thread (host case, differential table and management plan) |
| Length | About 489 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 3
Case Study 3: Coughing Until She Turns Red
Coughing Until She Turns Red: A Hosted Case Study on Pertussis in a 3-Month-Old and Protecting the Household
Host Post: The Case
R., a 3-month-old girl, has had a cough for two weeks that began like a cold. Over the past five days it has come in spells of many coughs in a row, after which she vomits. Last night during a spell she turned red, then pale, and seemed to stop breathing for a few seconds. Between spells she looks well and feeds. Temperature is normal, respiratory rate is 40, oxygen saturation is 97% at rest, and her lungs are clear.
Subjective Questions and Host Answers
Vaccines so far? Her 2-month vaccines were delayed and not yet given. Did her mother receive Tdap during pregnancy? No. Anyone at home with a cough? Her 12-year-old brother has had a cough for three weeks. Fever? No. Eye discharge at birth or since? No. Choking during feeds or a possible small object? No.
Differential Diagnosis Table
| Condition considered | Findings for | Findings against |
|---|---|---|
| Pertussis | Paroxysmal cough, post-tussive vomiting, apnea, unvaccinated, coughing contact, afebrile | None |
| RSV bronchiolitis | Young infant, cough | Wheeze, crackles, tachypnea, increased work of breathing |
| Chlamydia trachomatis pneumonia | Afebrile, young infant with cough | Staccato cough, tachypnea, conjunctivitis history |
| Gastroesophageal reflux | Vomiting | Vomiting follows coughing spells rather than feeds; reflux does not cause paroxysms |
| Foreign body aspiration | Cough with color change | Witnessed choking, focal findings, mobile age group |
Management Plan
Most probable diagnosis: pertussis in an unvaccinated 3-month-old, with apnea.
Testing: Nasopharyngeal swab for Bordetella pertussis PCR, which is most sensitive in the first three to four weeks of cough, and a complete blood count, where marked lymphocytosis supports the diagnosis and very high white counts signal risk in young infants.
Treatment: Admit her. Infants younger than 6 months with apnea or color change need monitoring, and young infants carry the highest risk of death from pertussis (Kimberlin et al., 2024). Start azithromycin without waiting for results: 10 mg/kg once daily for 5 days in infants younger than 6 months, the preferred agent because erythromycin has been linked to pyloric stenosis in young infants (Tiwari et al., 2005).
Supporting article: The CDC treatment and prophylaxis guidelines review the evidence on macrolide choice, dosing and timing for infants and contacts (Tiwari et al., 2005).
Anticipatory guidance and contacts: All household members, including the brother, should receive antibiotic prophylaxis regardless of their vaccination status. The brother should be tested and stay home until 5 days of treatment are complete. R.'s vaccines should be brought up to date at discharge. Tdap is recommended in every pregnancy, between 27 and 36 weeks, to protect infants before they can be vaccinated (Liang et al., 2018).
Family websites: CDC pertussis pages for parents and HealthyChildren.org on whooping cough.
Follow-up: Report the case to public health as required. After discharge, see her within 48 hours; the cough may last weeks, so teach parents to recognize apnea and color change.
References
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.
Liang, J. L., Tiwari, T., Moro, P., Messonnier, N. E., Reingold, A., Sawyer, M., & Clark, T. A. (2018). Prevention of pertussis, tetanus, and diphtheria with vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recommendations and Reports, 67(2), 1-44. https://doi.org/10.15585/mmwr.rr6702a1
Tiwari, T., Murphy, T. V., & Moran, J. (2005). Recommended antimicrobial agents for the treatment and postexposure prophylaxis of pertussis: 2005 CDC guidelines. MMWR Recommendations and Reports, 54(RR-14), 1-16.
DNP 645 Module 3 instructions, in plain terms
The lower respiratory module in Week 7 brings the third hosted case of DNP 645, following the second immersion. By Sunday morning the hosts have posted their patient and assigned each pair a part to play. Early in the week, classmates ask for the history and examination details that will separate the possibilities; by Wednesday a five-diagnosis table appears with the case findings each diagnosis does and does not explain; and the plan writers then cover testing, treatment, a high-level supporting article, family guidance, reliable websites and follow-up. Respiratory cases in infants often depend on immunization history, contacts and the level of care, so these belong in your questions and your plan.
How this DNP 645 Module 3 example is built
Built as a full hosted thread, the sample starts with the host's description of the cough and the episode of color change. The subjective section asks the questions that matter most in infant cough, vaccines, maternal Tdap, coughing contacts, fever, eye discharge and choking, with the host's answers. A differential table weighs pertussis against bronchiolitis, chlamydial pneumonia, reflux and a foreign body, showing which details are present or absent. The management post names the diagnosis, orders PCR and a blood count, sets the level of care, gives azithromycin with dose and the reason it is preferred, cites the CDC guidelines, extends prophylaxis to the household, addresses maternal and infant vaccination and lists websites and follow-up.
Reading the DNP 645 Module 3 grading rubric
Faculty score the third case on the posted case study rubric, 10 points of the 30% the series carries. In infant respiratory cases, credit commonly goes to questions about vaccines, exposures and episodes of apnea or color change, a differential that weighs infections and non-infectious causes against the age of the patient, and a plan that chooses the right setting of care, gives drug and dose with age-specific safety reasoning and extends to household contacts and public health reporting where required. A plan that sends home an infant who needs monitoring would lose significant credit. Hosts earn their score through a well-built case and quick answers.
DNP 645 Module 3 help: mistakes that cost marks
The commonest gap in infant cough cases is a plan that treats only the baby. Ask who else in the home is coughing, and include them. Another is skipping the decision about where the infant should be cared for; say whether admission is needed and why. Give the antibiotic with its dose and the reason it was chosen for this age. Use vaccination status as a case detail in your table. Report to public health when the condition is notifiable. Cite the CDC and AAP for recommendations. If you would like a check of your role post, share the host's case and your assigned part with the desk. A short teaching section on recognizing apnea at home is part of a complete discharge plan.
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 645 Module 3 questions, answered
Where can I find a free DNP 645 Module 3 sample paper?
This page carries a full DNP 645 Module 3 sample: a hosted respiratory case study on pertussis in a 3-month-old, with the differential table and a plan for the infant and household.
Why do young infants with pertussis need admission?
Infants under about 6 months can have apnea, color change and severe complications, and they have the highest risk of death, so many need monitoring in hospital.
Which antibiotic is used for pertussis in young infants?
Azithromycin is preferred; erythromycin has been linked to pyloric stenosis in young infants.
Who should receive pertussis prophylaxis?
All household contacts and other close contacts, regardless of their own vaccination status, especially where there are infants or pregnant women.
What does Week 7 of DNP 645 cover?
Lower respiratory disorders, with Case Study 3 running all week and Quiz 7 due.