| Course | DNP 647 Management of Complex and Chronic Health Problems in Pediatric Primary Care |
|---|---|
| Module | Module 2 |
| Paper type | Hosted case study thread (host case, differential table and management plan) |
| Length | About 431 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 2
Case Study 2: The Teacher Says She Stares
The Teacher Says She Stares: A Hosted Case Study on Recognizing and Treating Childhood Absence Epilepsy in a 7-Year-Old
Host Post: The Case
A., a 7-year-old girl, comes to clinic because her second-grade teacher says she "zones out" many times a day, stops talking mid-sentence and then continues as if nothing happened. Her parents have noticed the same at dinner. Each spell lasts a few seconds. Her grades have slipped this term. Her neurological examination is normal.
Subjective Questions and Host Answers
Can she be brought out of a spell by touch or her name? No; she does not respond during the spell. Eyelid flutter or lip smacking? Eyelid flutter in some spells. Confusion afterward? None; she resumes immediately. How many a day? Her teacher counted more than 20. Prior febrile seizures or family history of epilepsy? A cousin with seizures. Sleep? Normal. In the office, two minutes of hyperventilation produced a 10-second spell with eyelid flutter.
Differential Table
| Diagnosis | Points toward it | Points away from it |
|---|---|---|
| Childhood absence epilepsy | Brief frequent spells, unresponsive, eyelid flutter, no postictal state, provoked by hyperventilation | EEG pending |
| Daydreaming | Staring | Interruption by touch, situational onset; she cannot be roused |
| ADHD, inattentive type | Slipping grades, inattention | Inattention is continuous, not brief episodes with flutter |
| Focal impaired awareness seizures | Unresponsive staring, automatisms | Longer spells, aura, postictal confusion |
| Sleep deprivation | Inattention | Normal sleep history |
Management Plan
Most probable diagnosis: childhood absence epilepsy, a generalized nonmotor seizure type in the ILAE classification (Fisher et al., 2017).
Testing: EEG with hyperventilation, expected to show generalized 3 Hz spike-and-wave discharges. Imaging is not routinely needed when the history, examination and EEG are typical. Refer to pediatric neurology.
Treatment: Ethosuximide is first-line therapy. In a randomized double-blind trial of children with newly diagnosed childhood absence epilepsy, ethosuximide and valproic acid were more effective than lamotrigine, and ethosuximide had fewer attentional side effects than valproic acid (Glauser et al., 2010). It is started at a low dose and titrated by neurology, with gastrointestinal upset as the common early side effect.
Supporting article: Glauser et al. (2010), a Level I randomized trial, supports ethosuximide as the first choice.
Anticipatory guidance: Supervised swimming and bathing only; helmet for biking; inform the school, since spells can explain missed instructions; good sleep. Most children outgrow childhood absence epilepsy by adolescence, though some develop other seizure types (Kliegman et al., 2024).
Family websites: Epilepsy Foundation pages on absence seizures and the Child Neurology Foundation.
Follow-up: Primary care visit within two weeks of starting therapy to review side effects and school reports; ask the teacher to count spells again.
References
Fisher, R. S., Cross, J. H., French, J. A., Higurashi, N., Hirsch, E., Jansen, F. E., Lagae, L., Moshe, S. L., Peltola, J., Roulet Perez, E., Scheffer, I. E., & Zuberi, S. M. (2017). Operational classification of seizure types by the International League Against Epilepsy: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 58(4), 522-530. https://doi.org/10.1111/epi.13670
Glauser, T. A., Cnaan, A., Shinnar, S., Hirtz, D. G., Dlugos, D., Masur, D., Clark, P. O., Capparelli, E. V., & Adamson, P. C. (2010). Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. New England Journal of Medicine, 362(9), 790-799. https://doi.org/10.1056/NEJMoa0902014
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 647 Module 2 assignment instructions
Week 4 brings neurological disorders and the second hosted case of DNP 647. The hosts post their patient by Sunday morning, and the group then asks, compares and plans in turn as the days pass. Neurological cases in children often begin with a report from school or home that could describe a seizure or a behavior, so the most valuable questions are about what the episodes look like, whether the child responds during them and what happens afterward. Teachers and parents are often the best witnesses, so questions about what they saw are part of the history. Because the episodes may be brief and frequent, ask the host how many happen in a day and in what settings, since frequency helps separate seizure types.
How this DNP 647 Module 2 example is built
Laid out as a full hosted week, the sample begins with the host's case built around a teacher's report. The subjective section asks about responsiveness, automatisms, postictal state, frequency, family history and sleep, and it reports an in-office hyperventilation test, which a question asker might request. The differential table compares absence epilepsy with daydreaming, inattentive ADHD, focal seizures and sleep deprivation using present and absent details. The management plan names the diagnosis within the ILAE classification, orders the confirming EEG, refers to neurology, chooses ethosuximide with the randomized trial behind it, gives safety and school guidance and the expected course, lists websites and sets follow-up with a school measure.
Where the marks sit in the DNP 647 Module 2 rubric
Ten points are available for Case Study 2. Faculty tend to credit history questions that capture the features of the episodes, a table that separates seizures from behavior and from other seizure types on clear criteria, and a plan that orders the confirming test, refers to neurology, chooses first-line therapy on the basis of evidence and covers safety and school. Plans lose credit when they order imaging by default, skip water safety or choose a second-line drug without explanation. The attached article should support the drug decision, ideally a randomized trial. Hosts are scored on the clarity of their case and how quickly they answer.
DNP 647 Module 2 help from the desk
Staring spells are often written up as attention problems; ask whether the child can be interrupted and whether there is confusion afterward. Explain when imaging is and is not needed rather than ordering it automatically. Give the first-line drug and the trial behind it. Make water safety explicit, since it is the most important safety point for absence seizures. Ask the school to count episodes again after treatment starts. Use the ILAE seizure terms. A second reader at the desk can look over your post first if you pass along the case and your part in it. If the case mentions grades slipping, link the plan to a school conversation and a recheck of performance once spells are controlled.
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 2 questions, answered
Where can I find a free DNP 647 Module 2 sample paper?
The full DNP 647 Module 2 sample is posted here: a hosted neurological case study on childhood absence epilepsy in a 7-year-old, with the differential table and treatment plan.
How do you tell absence seizures from daydreaming?
A daydreaming child can usually be interrupted by touch or name; a child in an absence seizure cannot, and spells are brief, frequent and often provoked by hyperventilation.
What is first-line treatment for childhood absence epilepsy?
Ethosuximide, which a randomized trial found as effective as valproic acid and better tolerated for attention, with both more effective than lamotrigine.
What does an EEG show in absence epilepsy?
Bursts of 3-per-second spike-and-wave activity across both hemispheres, which overbreathing commonly brings out.
What does Week 4 of DNP 647 cover?
The neurology module, whose seven days are given over to the second hosted case alongside the fourth quiz.