| Course | DNP 647 Management of Complex and Chronic Health Problems in Pediatric Primary Care |
|---|---|
| Module | Module 1 |
| Paper type | Hosted case study thread (host case, differential table and management plan) |
| Length | About 457 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 647 Module 1
Case Study 1: Two Emergency Visits Since Spring
Two Emergency Visits Since Spring: A Hosted Case Study on Stepping Up Care for a 10-Year-Old With Uncontrolled Asthma
Host Post: The Case
J., a 10-year-old boy with asthma diagnosed at 5, has needed two emergency visits since April, each treated with oral steroids. He was prescribed a low-dose inhaled corticosteroid last year but takes it "when he remembers." Most days he reaches for albuterol, and a nighttime cough wakes him roughly twice weekly. His lungs are clear today, and his height and weight are normal for age.
Subjective Questions and Host Answers
Can he show us how he uses his inhaler? He uses the inhaler without a spacer and inhales too fast. Triggers? Cats at his father's house, colds and soccer. Smoke exposure? His mother smokes outdoors. Nasal symptoms? Year-round congestion. Heartburn or symptoms with meals? No. Childhood Asthma Control Test? Score 14.
Differential Table
| Diagnosis or contributor | Explains these details | Does not explain |
|---|---|---|
| Uncontrolled persistent asthma | Frequent daytime and night symptoms, two oral steroid courses, ACT 14 | None |
| Poor inhaler technique and adherence | No spacer, fast inhalation, missed controller doses | None |
| Allergic rhinitis | Year-round congestion, cat exposure | Testing pending |
| Vocal cord dysfunction | Exercise symptoms | Inspiratory noise, throat tightness, response to albuterol argues against |
| Gastroesophageal reflux | Night cough | Heartburn, symptoms with meals |
Management Plan
Most probable diagnosis: moderate persistent asthma, not well controlled, with poor technique, partial adherence, cat and smoke exposure and likely allergic rhinitis.
Testing: Spirometry with bronchodilator response to document obstruction and severity. A Childhood Asthma Control Test score of 19 or below indicates poor control, and J.'s 14 confirms it (Liu et al., 2007). Consider allergy testing for cat and dust mite.
Treatment: Correct technique first with a valved spacer, then step up. For children 5 to 11 with moderate persistent asthma, the 2020 focused update prefers one budesonide-formoterol inhaler for both daily control and symptom relief over raising the steroid dose alone (National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group, 2020). Prescribe the 80/4.5 mcg budesonide-formoterol inhaler for scheduled twice-daily use plus single puffs for symptoms, staying under the labeled daily maximum. Treat allergic rhinitis with an intranasal corticosteroid (Kliegman et al., 2024).
Supporting article: The 2020 focused update reviews randomized trials showing fewer exacerbations with single maintenance and reliever therapy in this age group (National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group, 2020).
Anticipatory guidance: Written asthma action plan; school medication authorization; cat-free bedroom at his father's home; smoking cessation support for his mother; annual influenza vaccine.
Family websites: The American Lung Association's asthma pages and the Allergy and Asthma Network.
Follow-up: Recheck in 4 weeks with a repeat control test and technique check; step down after three months of good control.
References
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.
Liu, A. H., Zeiger, R., Sorkness, C., Mahr, T., Ostrom, N., Burgess, S., Rosenzweig, J. C., & Manjunath, R. (2007). Development and cross-sectional validation of the Childhood Asthma Control Test. Journal of Allergy and Clinical Immunology, 119(4), 817-825. https://doi.org/10.1016/j.jaci.2006.12.662
National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. (2020). 2020 focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. Journal of Allergy and Clinical Immunology, 146(6), 1217-1270. https://doi.org/10.1016/j.jaci.2020.10.003
DNP 647 Module 1 instructions, in plain terms
Asthma opens the DNP 647 case series in Week 2, the respiratory module, which also holds the first immersion and the Barkley readiness pre-test. Four times a term, a host group of three posts a patient and the rest of the class works the case in pairs: one pair draws out the history and exam, another sets five possible diagnoses side by side with the findings each explains, and a third writes the management plan, attaching a strong study and adding teaching, family resources and follow-up. In a chronic disease course the first question is often why a known condition is not controlled, which makes technique, adherence and triggers the place to start.
How the DNP 647 Module 1 example is put together
The sample presents a full case week in the order the syllabus sets. The host post gives the history of control, symptoms and controller use. The subjective section shows questions on technique, triggers, smoke, nasal symptoms, reflux and a control test score, with answers. The table combines rival diagnoses with contributors to poor control, each marked present or absent. The management plan names the most probable problem list, orders spirometry and possible allergy testing, corrects technique, steps up to single maintenance and reliever therapy with dose and maximum, treats rhinitis, cites the 2020 focused update and a validation study, adds the action plan, school forms, trigger control and smoking cessation support and sets a four-week recheck.
DNP 647 Module 1 rubric: what earns full marks
The first case study is worth 10 points, and the four cases together count for 30% of the grade. Chronic disease posts are generally credited when the history questions uncover the reasons for poor control, when the table mixes rival diagnoses with contributing factors, and when the plan checks technique and adherence before adding medication, names the regimen with dose and limits and sets a measurable recheck. Faculty also look for an action plan and school paperwork in asthma care. Stepping up treatment without explaining why the current plan failed, or citing superseded guidelines, are frequent deductions. A plan that shows the child's control test score at baseline and names the score that would trigger a step down reads as a complete chronic care plan.
DNP 647 Module 1 help from the desk
Ask to see the inhaler being used before changing it; poor technique explains a large share of uncontrolled asthma. Name the 2020 focused update when you recommend single maintenance and reliever therapy, and give the daily maximum. Treat contributing problems such as allergic rhinitis and smoke exposure as part of the plan. Use a validated control test at baseline and at the recheck. Write an asthma action plan, not just a prescription. Choose a supporting study that tested your regimen in children. If you want your role post reviewed, the desk can look at it alongside the host's case. Remember that a child at a parent's second home may face different triggers, so ask about each household.
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 647 Module 1 questions, answered
Where can I find a free DNP 647 Module 1 sample paper?
You can read the whole DNP 647 Module 1 sample here, a hosted asthma case week for a boy of 10 that ends in a step-up plan.
What is single maintenance and reliever therapy for asthma?
A single budesonide-formoterol inhaler serves as both the daily controller and the rescue puff, an approach the 2020 update favors for many children 5 and older with moderate persistent asthma.
What score on the Childhood Asthma Control Test means poor control?
A score of 19 or below suggests asthma is not well controlled and calls for a review of technique, adherence, triggers and treatment.
What should be checked before stepping up asthma treatment?
Inhaler technique, adherence, trigger exposure and coexisting conditions such as allergic rhinitis, since these often explain poor control.
How many case studies does DNP 647 have?
There are four, one each in Weeks 2, 4, 6 and 9, and together they make up 30% of the grade.