DNP 645 Module 5 Injury Case Study: Dog Bite Example

Course	DNP 645 Management of Common Problems in Pediatric Primary Care
Module	Module 5
Paper type	Hosted case study thread (host case, differential table and management plan)
Length	About 528 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 5

Case Study 5: Bitten Reaching for the Ball

Bitten Reaching for the Ball: A Hosted Case Study on a Dog Bite to an 8-Year-Old's Hand, From Wound Care to Rabies Decisions

Host Post: The Case

S., an 8-year-old boy, was bitten on the back of his right hand about 16 hours ago by a neighbor's dog while reaching for a ball under the dog's bench. His mother washed it with soap and water. There are two puncture wounds, each about 5 mm, over the back of the hand near the knuckle of the middle finger, with mild surrounding redness and swelling. He can fully extend and flex all fingers, sensation is intact and capillary refill is brisk.

Subjective Questions and Host Answers

Is the dog known, vaccinated against rabies and available to observe? Yes, the neighbor's dog, vaccinated, and the owner agrees to observation. Was the bite provoked? Yes, he reached near the dog's food. Tetanus vaccines? Up to date; last dose at age 5. Pain, fever, red streaks or pus? Mild pain, no fever. Allergies? None. Hand dominance? Right-handed.

Differential Table of Injury and Infection Possibilities

Injury or complication	Suggested by	Argued against by
Uncomplicated puncture wounds	Two small punctures, intact function	Signs of deep injury
Early wound infection (Pasteurella, staphylococci, streptococci, anaerobes)	Mild redness and swelling at 16 hours	Fever, spreading redness, pus
Extensor tendon injury	Punctures over the knuckle	Weakness in extension; tendons can be partially cut with full movement
Joint penetration (septic arthritis risk)	Bite near a knuckle	Pain on joint movement, joint swelling
Retained tooth fragment or fracture	Bite with pressure over bone	Bony tenderness, foreign body sensation

What this page is doingThe table adapts the five-diagnosis format to an injury, listing the complications the plan must exclude, and notes that full movement does not rule out a partial tendon cut, a frequent oversight.

Management Plan

Most probable diagnosis: provoked dog bite to the dominant hand with puncture wounds and early inflammation, at high risk of infection.

Testing: Radiographs of the hand if there is bony tenderness, concern for a retained tooth or a bite over a joint; here, an X-ray is reasonable because the bite lies over the knuckle. Culture only if the wound becomes infected.

Treatment: Irrigate thoroughly with saline under pressure. Leave puncture wounds open rather than suturing them, since hand punctures carry a high infection risk. Elevate the hand. Give amoxicillin-clavulanate at weight-based dosing for 3 to 5 days as prophylaxis, recommended for bites to the hand and for punctures (Stevens et al., 2014). His tetanus vaccination is current within 5 years, so no booster is needed. The dog is vaccinated and available for 10 days of observation, so rabies postexposure prophylaxis is not needed unless the dog becomes ill (Kimberlin et al., 2024); report the bite to local animal control as required.

Supporting article: A Cochrane review found that antibiotic prophylaxis reduced infection after mammalian bites to the hand, while evidence for other sites was weaker (Medeiros & Saconato, 2001).

Anticipatory guidance: Teach S. never to reach near a dog that is eating, sleeping or caring for puppies, and to ask the owner before touching a dog.

Family websites: HealthyChildren.org on dog bites and the CDC page on rabies after an animal bite.

Follow-up: Recheck in 48 hours, sooner for fever, red streaks, increasing pain or swelling or reduced finger movement, which would suggest deep infection and need for hand surgery evaluation.

What this page is doingThe plan walks through each decision a clinician must make after a bite, wound closure, antibiotic, tetanus and rabies, giving the case-specific reason for each answer.

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.

Medeiros, I., & Saconato, H. (2001). Antibiotic prophylaxis for mammalian bites. Cochrane Database of Systematic Reviews, 2001(2), Article CD001738. https://doi.org/10.1002/14651858.CD001738

Stevens, D. L., Bisno, A. L., Chambers, H. F., Dellinger, E. P., Goldstein, E. J. C., Gorbach, S. L., Hirschmann, J. V., Kaplan, S. L., Montoya, J. G., & Wade, J. C. (2014). Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 59(2), e10-e52. https://doi.org/10.1093/cid/ciu296

What the DNP 645 Module 5 instructions ask for

Pediatric injuries and toxic exposures close the DNP 645 hosted series in Week 13, the week after the third immersion and OSCE. Roles rotate one last time: the hosts post the case and answer questions, the history pair asks what is missing, the differential pair lists five possibilities with the details for and against each, and the management pair posts the plan with an attached article of high evidence level, family teaching, websites and follow-up. In an injury case, the five possibilities are often complications rather than rival diagnoses, and the plan is a sequence of decisions about wound care, antibiotics, immunizations and reporting. Read the host's description of the wound carefully, since location and depth shape every later decision.

How the DNP 645 Module 5 example is put together

Following a hosted case week, the sample begins with the host's description of the bite and the hand examination. The subjective section gathers the facts that drive the decisions: the dog's vaccination and availability, provocation, tetanus status and hand dominance. Because an injury has complications rather than rival diagnoses, the table lists five possibilities, from simple punctures to tendon, joint and bone injury, marking present and absent details. The management plan sets imaging, irrigation, leaving the wounds open, the prophylactic antibiotic, the tetanus decision and the rabies decision with their reasons, cites a Cochrane review and the IDSA guideline, teaches prevention, lists websites and gives a 48-hour recheck with warning signs.

DNP 645 Module 5 rubric: what earns full marks

Scored like the earlier four, the final case is worth up to 10 points. For injury cases, credit usually follows questions that gather the facts each decision depends on, a table of complications that is honest about what is and is not present, and a plan that makes each decision explicitly: whether to close the wound, whether to give antibiotics and which, whether tetanus or rabies prophylaxis is needed and what must be reported. Deductions follow from closing high-risk wounds, skipping prophylaxis where it is indicated or deciding about rabies without assessing the animal. The article attached should support the antibiotic or wound care choice.

DNP 645 Module 5 help: mistakes that cost marks

Injury plans often say to consider tetanus and rabies without deciding. Make each decision and give the reason drawn from the case. Another common miss is assuming normal finger movement rules out tendon injury; plan a recheck. For bites to the hand, explain why the wound is left open. Teach prevention to the child in words a child can use. Use the infectious diseases guideline for antibiotics and a systematic review for the evidence. Name the reporting requirement in your community. If you want a second look before posting, share your role and the host's case with the desk. State the follow-up interval and the specific signs that should bring the family back sooner.

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 5 questions, answered

Where can I find a free DNP 645 Module 5 sample paper?

The DNP 645 Module 5 sample on this page is a full hosted injury case study on a dog bite to an 8-year-old's hand, from wound care to rabies decisions.

Should dog bites to the hand get antibiotics?

Yes. Prophylactic amoxicillin-clavulanate is recommended for bites to the hand and for puncture wounds, which have a high risk of infection.

Should a dog bite on the hand be stitched?

Puncture wounds and most bites to the hand are left open after irrigation because closure raises the risk of infection.

When is rabies prophylaxis needed after a dog bite?

When the dog cannot be observed, is suspected of rabies or becomes ill during observation; a healthy, vaccinated dog can be watched for 10 days.

What does Week 13 of DNP 645 cover?

Pediatric injuries and toxic exposures, with Case Study 5 running all week and Quiz 12 due.

DNP 645 Module 5 Case Study 5: Pediatric Injuries and Toxic Exposures (Dog Bite to the Hand) Example