DNP 647 Module 3 Case Study 3: Gastrointestinal Disorders (Celiac Disease) Example

Reviewed by Ingrid Vasterling, MSN, RN Arizona State University Updated October 2026

This DNP 647 Module 3 sample works through Case Study 3, the gastrointestinal week, in Management of Complex and Chronic Health Problems in Pediatric Primary Care, a course in the ASU Doctor of Nursing Practice. ASU DNP 647 places this case in its gastrointestinal week, Week 6, where pairs share out the questioning, the comparison of diagnoses and the plan. The case concerns a composite girl of 8 with on-and-off abdominal pain, loose stools and a height that has fallen from the 50th to the 15th percentile over two years. The thread gathers diet and family history, compares celiac disease with four other causes, orders the right serology while she still eats gluten and sets a plan of biopsy referral, a gluten-free diet with a dietitian, family screening and follow-up.

CourseDNP 647 Management of Complex and Chronic Health Problems in Pediatric Primary Care
ModuleModule 3
Paper typeHosted case study thread (host case, differential table and management plan)
LengthAbout 439 words
FormatDiscussion post with APA 7 citations
SchoolArizona State University
ProgramDoctor of Nursing Practice
UpdatedOctober 2026

Free sample paper for DNP 647 Module 3

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Case Study 3: Falling Off Her Growth Curve

Falling Off Her Growth Curve: A Hosted Case Study on Testing for and Managing Celiac Disease in an 8-Year-Old

Host Post: The Case

M., an 8-year-old girl, has had abdominal pain a few times a week and loose stools for about a year. She is often tired. Over two years she has slid from the 50th height percentile to the 15th, and from the 40th weight percentile to the 10th. Her abdomen is mildly distended and nontender. She has no blood in her stools.

Subjective Questions and Host Answers

Diet? A typical diet with bread, pasta and cereal daily. Family history? Her mother has type 1 diabetes; an aunt has thyroid disease. Travel, well water or child care outbreaks? None. Symptoms with milk? No clear link. Mouth ulcers, rashes or joint pain? None. Fatigue, cold intolerance or constipation? Fatigue only.

Differential Table

DiagnosisConsistent findingsInconsistent or missing findings
Celiac diseaseGrowth failure, loose stools, distension, fatigue, family autoimmune diseaseSerology pending
Inflammatory bowel diseaseAbdominal pain, growth failureBlood in stool, mouth ulcers, joint pain, nighttime stools
GiardiasisLoose stools, distensionExposure history; chronic course with growth failure is less typical
Lactose intoleranceLoose stools, painLink to milk; it would not explain growth failure
HypothyroidismFatigue, slowed growthConstipation, cold intolerance, weight gain
What this page is doingThe table weighs each diagnosis against the growth failure, the finding that separates disorders that damage absorption or growth from those that cause only symptoms.
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Management Plan

Most probable diagnosis: celiac disease.

Testing: Anti-tissue transglutaminase IgA, paired with a total IgA, drawn while gluten is still in her diet; if total IgA is low, use an IgG-based test (Hill et al., 2016). Add a complete blood count, ferritin, thyroid tests and a comprehensive metabolic panel. Do not start a gluten-free diet before testing is complete, because it can make serology and biopsy falsely normal.

Referral: Refer to pediatric gastroenterology for confirmation, usually by small bowel biopsy; some children with very high antibody levels may be diagnosed without biopsy under specialist protocols (Rubio-Tapia et al., 2023).

Treatment: A strict lifelong gluten-free diet after confirmation, taught by a dietitian experienced in celiac disease, with attention to cross-contamination at home and school. Treat iron deficiency if present.

Supporting article: The NASPGHAN clinical report summarizes the evidence on serologic testing, biopsy and the gluten-free diet in children (Hill et al., 2016).

Anticipatory guidance: Screen first-degree relatives with serology. Her mother's type 1 diabetes and the aunt's thyroid disease fit the clustering of autoimmune conditions with celiac disease (Kliegman et al., 2024). Plan for school lunches and birthday parties.

Family websites: The Celiac Disease Foundation and the NASPGHAN Foundation's GIKids pages.

Follow-up: Recheck growth every three to six months and repeat tissue transglutaminase IgA at six months to confirm adherence and falling antibody levels.

What this page is doingThe plan protects the accuracy of the test by keeping gluten in the diet until testing is done, a step often missed in primary care, and it extends care to the family.
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References

Hill, I. D., Fasano, A., Guandalini, S., Hoffenberg, E., Levy, J., Reilly, N., & Verma, R. (2016). NASPGHAN clinical report on the diagnosis and treatment of gluten-related disorders. Journal of Pediatric Gastroenterology and Nutrition, 63(1), 156-165. https://doi.org/10.1097/MPG.0000000000001216

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.

Rubio-Tapia, A., Hill, I. D., Semrad, C., Kelly, C. P., Greer, K. B., Limketkai, B. N., & Lebwohl, B. (2023). American College of Gastroenterology guidelines update: Diagnosis and management of celiac disease. American Journal of Gastroenterology, 118(1), 59-76. https://doi.org/10.14309/ajg.0000000000002075

DNP 647 Module 3 instructions, in plain terms

Case Study 3 fills Week 6, the gastrointestinal module, in a week that also holds a formative simulation and the second immersion. As before, the case goes up on Sunday and the pairs take their turns through the week, ending with a plan that rests on a well-designed study. Gastrointestinal cases in children frequently hinge on the growth chart, so bring growth velocity into your questions and your plan whatever your role. Ask about the family's diet in specific terms, since the timing of testing depends on whether the child is still eating gluten. Weight and height trends belong in your first questions as well as your plan.

How the DNP 647 Module 3 example is put together

Arranged as a hosted case week, the sample starts with a host post centered on the growth chart. The subjective section asks about diet, family autoimmune disease, exposures, milk, extraintestinal signs and thyroid symptoms, with answers. The differential table compares celiac disease with inflammatory bowel disease, giardiasis, lactose intolerance and hypothyroidism, using growth failure as the key discriminator. The management plan names the probable diagnosis, orders serology with total IgA and supporting labs while warning against starting the diet early, refers for confirmation and notes the no-biopsy pathway, sets a dietitian-led gluten-free diet, cites the NASPGHAN report and ACG guideline, adds family screening and school planning, lists websites and schedules follow-up serology and growth checks.

Where the marks sit in the DNP 647 Module 3 rubric

Up to 10 points are awarded for the third case. For gastrointestinal cases, faculty usually credit questions about diet, family history and red flags, a table built on features that truly separate the diagnoses, and a plan that orders tests in the right sequence, refers when confirmation is needed, uses guideline-based treatment, includes relatives and sets follow-up that measures growth. Deductions often follow from starting a diet before testing, from omitting a total IgA level and from leaving family screening out. Plan your role post before the busy immersion week begins. Plans that tie follow-up serology to a date and explain what a falling antibody level means show the measurable follow-up graders want.

DNP 647 Module 3 help from the desk

The error that most often undermines a celiac plan is advising a gluten-free trial before testing; keep gluten in the diet until the work-up is complete and say why. Order total IgA with the antibody test. Use the growth chart as evidence and recheck it at follow-up. Involve a dietitian and screen first-degree relatives. Cite pediatric and adult guidelines where they agree. If your role is the differential, use growth failure to separate conditions that affect absorption from those that only cause symptoms. The desk can review your post if you share the host's case with it. Watch for other autoimmune conditions in the family history, since they raise the chance of celiac disease and may call for screening of their own.

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DNP 647 Module 3 questions, answered

Where can I find a free DNP 647 Module 3 sample paper?

This page carries a full DNP 647 Module 3 sample: a hosted GI case study on celiac disease in an 8-year-old with growth failure, with the differential table and plan.

What is the first test for celiac disease in children?

An anti-tissue transglutaminase IgA level paired with total IgA, measured while gluten remains in the diet.

Why should a child keep eating gluten before celiac testing?

Removing gluten lowers antibody levels and heals the intestine, which can make blood tests and biopsy falsely normal.

Should family members of a child with celiac disease be tested?

Yes. First-degree relatives have a higher risk and should be offered serologic screening.

What does Week 6 of DNP 647 cover?

The gut and liver module, which shares its week with the third hosted case, a practice simulation and the second campus immersion.