| Course | NR 328 Pediatric Nursing |
|---|---|
| Week | 6 |
| Paper type | Chronic illness care plan |
| Length | About 1,140 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 328 Week 6
Chronic Illness Care Plan: Cystic Fibrosis in an 8-Year-Old Boy at 26 kg, With the Enzyme Dose Due to Expire and a Grandmother on Tuesdays
Student Name
College of Nursing, Chamberlain University
NR 328: Pediatric Nursing
Instructor Name
Month Day, Year
Chronic Illness Care Plan: Cystic Fibrosis in an 8-Year-Old Boy at 26 kg, With the Enzyme Dose Due to Expire and a Grandmother on Tuesdays
The Child and the House
Noah is 8 and has cystic fibrosis with pancreatic insufficiency, diagnosed on his newborn screen; details have been changed. Today, at his quarterly clinic visit, he weighs 26.0 kilograms with a body mass index on the 42nd percentile, down from the 51st three months ago after a chest infection in the spring. He is in third grade. His mother works as a hospital unit clerk from 0700 to 1530. His father drives a long-haul truck and is home on weekends. His grandmother collects Noah and his 5-year-old sister from school on Tuesdays and Thursdays and keeps them until 1700. The family has used a chest physiotherapy vest for airway clearance for two years.
This plan is written for the people in that house and at Noah's school. Every task has a name on it, every figure that depends on his size has a date to be rechecked, and the last section says what Noah already does himself and what he takes on next.
Tasks With Names on Them
Table 1 assigns each daily task to the person who does it.
Table 1
Daily Tasks and Who Does Them
| Task | When | Who |
|---|---|---|
| Airway clearance with the vest, 20 minutes, then nebulized medicines as prescribed | 0615 before school | Mother, with Noah |
| Airway clearance, evening | 1800 | Mother on Mon, Wed, Fri; grandmother on Tue and Thu before handover; father on weekends |
| Enzymes with breakfast and dinner | At the first bite | Noah, checked by whoever serves the meal |
| Enzymes with lunch | At the first bite, school cafeteria | School nurse, who holds the supply |
| Enzymes with snacks | After school | Grandmother on Tue and Thu; mother otherwise |
| Daily vitamins for cystic fibrosis | With breakfast | Mother |
| Extra salt on food, and a salted drink on hot days or after sports | As needed | Noah, reminded by the adult present |
Note. The grandmother was taught the vest settings and the enzyme counts at today's visit and demonstrated both.
Figures That Expire
Noah takes two capsules of 12,000 lipase units with each meal and one with each snack. At 26.0 kilograms that is 24,000 units, or about 920 units per kilogram per meal. The pediatric nutrition consensus for cystic fibrosis advises starting at 500 lipase units per kilogram per meal in children over 4 and not exceeding 2,500 units per kilogram per meal or 10,000 per kilogram per day (Borowitz et al., 2002). His dose sits well within that range.
The figure will not stay right. He gains weight as he grows, and his dose in units per kilogram falls without anyone changing anything. For that reason the plan attaches a review point to every size-based figure: the enzyme dose, his nebulized medicine volumes and his calorie target are all rechecked at each quarterly clinic visit, and sooner if his weight changes by more than a kilogram between visits or his stools become greasy, frequent or foul-smelling, which suggest the dose is no longer enough.
The weight target itself comes from the evidence. Stallings et al. (2008), reviewing nutrition care for the Cystic Fibrosis Foundation, recommended a target of the 50th BMI percentile or higher for children with cystic fibrosis, because better nutrition is linked with better lung function. Noah's fall from the 51st to the 42nd is the reason for the plan's added high-calorie after-school snack and a dietitian visit in six weeks rather than at the next quarter.
The Hours Outside the House
School. The school nurse holds a supply of enzymes and a copy of this plan. Noah goes to the nurse's office at the start of lunch, not the end, because enzymes work only if taken as eating begins. He keeps a water bottle at his desk, may use the bathroom without asking, and has a written plan agreed with his teacher for coughing in class without being sent out. The school has been asked to keep him apart from any other student with cystic fibrosis, since the two can pass lung infections to each other.
The sleepover next month. His mother will send a labeled pill box with the exact enzymes for dinner, snacks and breakfast, and a note for the host parent. The evening vest session will be done at home before he leaves, and the morning session when he returns; one missed session is an accepted price of the sleepover going ahead.
Summer day camp. Camp staff will receive the plan, a supply of enzymes held by the camp nurse, and a salt plan for hot days, since children with cystic fibrosis lose more salt in sweat.
Home, on the days that go wrong. The plan also covers the hours when the named person cannot be there. If the grandmother is ill on a Tuesday, the school's after-care program keeps Noah until 1545 and his mother does the evening vest session late, at 1900, rather than skipping it. If his mother is held at work, the grandmother has a key and the vest settings are written on a card taped to the machine. The plan names the backup because a routine that depends on one person holds only as long as that person's week does.
A Bad Day, Written as a Threshold
Call the cystic fibrosis clinic the same day: a cough that is more frequent or wetter for more than two days; more sputum, or a change in its color; fever reaching 38.3 C; weight loss of half a kilogram or more on the home scale in two weeks; tiring more easily at recess, as reported by school.
Go to the emergency department: blood in the sputum more than a streak; breathing hard at rest; severe belly pain with vomiting, which in cystic fibrosis can mean a bowel blockage.
The Share That Moves to Noah
Noah already swallows his capsules, knows that he needs two with a meal and one with a snack, and starts the vest himself when an adult sets it up. The next step, over the coming school year, is for him to count his own enzymes into his pill box on Sunday evenings with his mother checking, and to tell the adult at a friend's house when he needs to take them, without being prompted. By about 10, if the school nurse agrees, he may carry a day's supply himself. Each step is small and can be observed, which is how the plan will know it has happened.
References
Borowitz, D., Baker, R. D., & Stallings, V. (2002). Consensus report on nutrition for pediatric patients with cystic fibrosis. Journal of Pediatric Gastroenterology and Nutrition, 35(3), 246-259. https://doi.org/10.1097/00005176-200209000-00004
Stallings, V. A., Stark, L. J., Robinson, K. A., Feranchak, A. P., & Quinton, H. (2008). Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: Results of a systematic review. Journal of the American Dietetic Association, 108(5), 832-839. https://doi.org/10.1016/j.jada.2008.02.020
Reading the NR 328 Week 6 instructions
For Week 6 you write a care plan for a child living with a chronic illness. Most sections require a description of the child and family, priority problems, goals, interventions with rationales, coordination with school or community, evaluation and evidence in APA. Describe the people in the house and at school, since they carry out the plan. Put a name on every task. Calculate any dose that depends on size and give it a date to be checked again. Include the places the child spends time away from home. State exactly when the family should call or go to the emergency department. End with the self-care the child takes on next.
Inside the NR 328 Week 6 example
The first section describes Noah's diagnosis on his newborn screen, today's weight and BMI percentile, and the household. Table 1 assigns the vest sessions, enzymes and medicines to his mother, his grandmother on Tuesdays and Thursdays, and the school nurse. The figures section calculates two 12,000-unit capsules per meal as about 920 lipase units per kilogram, compares it with the consensus range and explains that the figure falls as he grows. Stallings and colleagues supply the 50th percentile BMI target. The section on time away covers enzymes at the start of lunch, the sleepover pill box, camp salt and a sick grandmother. Thresholds follow, and the plan ends with Noah counting his own enzymes.
NR 328 Week 6 rubric: what full points look like
Chronic illness care plan rubrics usually award points for assessment of the child and family, prioritized problems, measurable goals, specific interventions with rationale, coordination of care, evaluation, evidence and APA. Interventions carry the most weight, and they earn credit here because each one names a person and a time. Assessment is credited for describing the household and school, not just the diagnosis. Goals score when they are measurable, such as the BMI target. Dose review dates show the attention to growth that separates pediatric from adult planning. Coordination earns points through the school nurse, camp and sleepover plans. Evaluation is met by clear thresholds for calling the clinic. Borowitz and colleagues and Stallings and colleagues support the evidence row.
NR 328 Week 6 help from the desk
The plan that loses most is an adult plan with a child's age typed on it, with the same problems and goals and no sense that other people manage the condition. Another common loss is handing every task to an unnamed caregiver. Students also give a weight-based dose with no date to recalculate, forget school entirely or describe warning signs without saying who to call. Plans that leave the child with no role at all miss the developmental row. Check every calculation against the source you cite. Avoid long sections on the genetics of the disease, which earn few points here. If your assigned child has diabetes or asthma, describe the household and an NR 328 chronic illness plan can be shaped around it.
Get a NR 328 Week 6 example written to your instructions
Send the Week 6 case and the care plan template your section issues, and a custom plan is built into it and returned inside 24 to 48 hours, first one free. Say how old the child is and how long the condition has been running, since both decide how much of the plan belongs to the child rather than to the adult beside them.
More NR 328 papers and pre-licensure samples
- NR 328 Week 1: Parent-Reported History Post
- NR 328 Week 2: Toddler Growth and Development Paper
- NR 328 Week 3: Well-Child Visit Write-Up
- NR 328 Week 4: Pediatric Dosage Calculation Set
- NR 328 Week 5: Pediatric Respiratory Case Response
- NR 328 Week 7: Family Teaching Handout
- NR 328 Week 8: Case Study Analysis
- NR 341 Week 6: Delegation Scenario Response
- NR 327 Week 6: Newborn Transition Write-Up
- NR 452 Week 6: Implementation Plan
- NR 326 Week 6: Psychotic Depression Case Study
NR 328 Week 6 questions, answered
Should the plan cover the whole condition or one problem?
Follow the number your section sets, and where none is set, a small count developed fully beats a long list. What this course adds to the usual reasoning is the household. Two well-argued problems that account for who does the task, where the child spends the day and what changes as they grow will always read better than six that could have been written about anybody.
How do I handle a teenager who does not follow the plan?
As a predictable feature of the age rather than as a character flaw. Wanting to be like everybody else at fourteen is ordinary, and a plan treating it as disobedience has misread the person it was written for. The stronger version changes the plan instead: fewer visible interventions during the school day, more responsibility handed across, and a check that does not need an adult standing there.
Does the school really need to be in a care plan?
For a school-age child it accounts for most of the waking hours the plan is meant to cover, so leaving it out removes the setting where things are most likely to go wrong. Name what the school has to hold, who supplies it, and what staff there are permitted to do before ringing anybody. Sections marking for realism look for exactly this and notice its absence.
Where can I find a free NR 328 Week 6 sample paper?
This page shows the complete Week 6 care plan for Noah, the task table with names, the enzyme calculation and review dates, school and camp plans, the call thresholds and both references.
Why does the NR 328 Week 6 plan put a review date on the enzyme dose?
Because Noah gains weight as he grows, so the same capsules give fewer lipase units per kilogram over time, and the dose can fall out of range without anyone changing it.