| Course | NR 602 Primary Care of the Childbearing and Childrearing Family Practicum |
|---|---|
| Week | 6 |
| Paper type | Pediatric SOAP note |
| Length | About 800 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Family Nurse Practitioner (FNP) |
| Updated | October 2026 |
Free sample paper for NR 602 Week 6
Pediatric SOAP Note: M.O. at 17 Months With Three Days of Fever and Reduced Drinking, the History Attributed, the Child Read Without Words and a Weight-Based Plan
Student Name
College of Nursing, Chamberlain University
NR 602: Primary Care of the Childbearing and Childrearing Family Practicum
Instructor Name
Month Day, Year
Pediatric SOAP Note: M.O. at 17 Months With Three Days of Fever and Reduced Drinking, the History Attributed, the Child Read Without Words and a Weight-Based Plan
Who Is Giving the History
History from M.O.'s parent, the main weekday caregiver, who has been with M.O. throughout the illness. M.O. is 17 months old and cannot describe symptoms.
Subjective, as Reported by the Parent
Fever for 3 days, highest 39.4 °C under the arm last night, brought down with acetaminophen.
Drinking less than usual for 2 days: "maybe half." Eating very little.
Wet diapers: 4 yesterday, against a usual 6 or 7. The last was 3 hours before the visit.
Pulling at the right ear since yesterday. Fussy at night.
Runny nose for 5 days before the fever began.
No vomiting, no diarrhea, no rash, no cough beyond the cold, no breathing difficulty.
Daycare: yes; two other children have colds.
Immunizations: up to date through 15 months.
Medicines: iron drops, started 2 months ago; acetaminophen as above.
Allergies: none known.
Objective: What the Child Supplies
Weight today: 9.4 kg. Weight at the 15-month visit: 9.6 kg; at 16 months: 9.8 kg. Loss since last month: 0.4 kg, about 4%.
Vital signs: rectal temperature 38.9 °C; pulse 148; breathing 30 a minute; saturation 98% on room air.
General: tired but alert, cries on examination and settles in the parent's arms; reaches for a toy when offered and plays with it briefly.
Hydration: mouth slightly sticky, tears present when crying, capillary refill under 2 seconds, eyes not sunken.
Ears: right eardrum red and bulging, with poor movement; left eardrum normal.
Throat: mild redness, no exudate.
Neck: supple, no stiffness when the child looks down at a toy.
Chest: clear, no increased work of breathing.
Skin: no rash.
On a clinical dehydration scale that scores appearance, eyes, mucous membranes and tears, M.O. scores 1, consistent with no or mild dehydration (Friedman et al., 2004).
Assessment
1. Acute otitis media, right ear, in a child under 2 with fever of 39 °C and a bulging eardrum.
2. Mild dehydration, about 4% weight loss, with reduced intake and fewer wet diapers.
3. Faltering weight gain, previously improving on reduced milk; today's loss reflects the acute illness.
Plan, Using Today's Weight
Amoxicillin, the first-line antibiotic for acute otitis media without recent amoxicillin use, at the high dose of 90 mg per kilogram per day, divided twice daily, for 10 days in a child under 2 (Lieberthal et al., 2013).
9.4 kg x 90 mg = 846 mg a day; 423 mg twice daily. Using the 400 mg per 5 mL suspension: 5.3 mL twice daily. Measured with the oral syringe, demonstrated to the parent.
Acetaminophen for pain and fever: 15 mg per kilogram, so 141 mg each time. From the 160 mg per 5 mL liquid that is 4.4 mL, at least 6 hours apart, capped at five doses a day.
Fluids: small sips every 15 to 20 minutes, of oral rehydration solution, water or diluted milk, aiming for four or more wet diapers a day.
Iron drops: pause while the child is unwell and not eating, restart when eating normally. Milk can be offered while M.O. is unwell, since fluids come first, but the daily limit that helped M.O.'s weight and iron returns once eating recovers (Baker & Greer, 2010).
Weight recheck in 1 week, then resume the growth follow-up plan. A note for the daycare explains the medicine schedule, asks staff to offer fluids often and to send M.O. home if fewer wet diapers are seen.
Return Precautions
The parent was asked to ring us, or bring M.O. back, the same day if:
- fewer than 3 wet diapers in 24 hours, or no wet diaper in 8 hours;
- M.O. is too sleepy to wake for a drink;
- no tears when crying, or the mouth becomes dry;
- fever is still present after 48 to 72 hours of the antibiotic;
- fluid or pus drains from the ear;
- a rash appears, especially one that does not fade when pressed;
- M.O. holds the neck stiffly or cries when the head is moved.
Call 911 for difficulty breathing, a seizure or if M.O. cannot be woken.
The parent repeated the amoxicillin dose and three of the precautions back correctly.
Follow-Up
The growth plan from the 15-month visit resumes once M.O. is well. Phone check in 48 hours by the clinic nurse. Visit in 1 week for weight. Ear recheck only if symptoms persist.
References
Baker, R. D., Greer, F. R., & Committee on Nutrition. (2010). Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics, 126(5), 1040-1050. https://doi.org/10.1542/peds.2010-2576
Friedman, J. N., Goldman, R. D., Srivastava, R., & Parkin, P. C. (2004). Development of a clinical dehydration scale for use in children between 1 and 36 months of age. The Journal of Pediatrics, 145(2), 201-207. https://doi.org/10.1016/j.jpeds.2004.05.035
Lieberthal, A. S., Carroll, A. E., Chonmaitree, T., Ganiats, T. G., Hoberman, A., Jackson, M. A., Joffe, M. D., Miller, D. T., Rosenfeld, R. M., Sevilla, X. D., Schwartz, R. H., Thomas, P. A., & Tunkel, D. E. (2013). The diagnosis and management of acute otitis media. Pediatrics, 131(3), e964-e999. https://doi.org/10.1542/peds.2012-3488
Reading the NR 602 Week 6 instructions
The Week 6 note treats the subjective section as testimony and says whose it is: a parent reports fever and reduced drinking, and that report is the only account of the illness. The objective section is where the child speaks without words: alertness, work of breathing, hydration, whether they can be consoled and whether they play when distracted. Record a current weight with the vital signs and use it in every dose. Give return precautions a parent can act on. Most rubrics mark down an adult note with a child's age on it, such as a toddler who denies chest pain, a missing weight and vague return precautions.
Inside the NR 602 Week 6 example
The sample names the parent as the source and lists fever, intake, wet diapers, ear pulling and the preceding cold. Objective findings include today's weight compared with two earlier visits, a 4% loss, vital signs, consolability, play, hydration signs, a bulging right eardrum and a supple neck, with a dehydration score of 1. Assessment lists acute otitis media, mild dehydration and the earlier growth concern. Amoxicillin and acetaminophen doses are calculated from 9.4 kilograms with volumes for the suspensions. Fluids, iron, milk and the daycare are addressed. Return precautions are listed as countable signs and checked by repeat-back. Margin notes show where the child's signs and the precautions earn credit.
Reading the NR 602 Week 6 grading rubric
The note that gives itself away fastest is an adult template with a child's age, and this note asks nothing a toddler could not answer. A missing weight costs the next share, while today's weight is compared with earlier visits and used in every dose. Return precautions that are absent or vague lose a row, and these are specific and counted. Recording the child's play and consolability earns the objective criterion. Showing the dose arithmetic lets a reader check safety. Linking the acute illness to the earlier growth plan completes the note. Pausing the iron drops and restarting the milk limit later shows the plan fits the child's other problems. Notes for the daycare carry the plan beyond the visit.
Common NR 602 Week 6 mistakes, and how to avoid them
Weak NR 602 Week 6 notes use an adult review of systems for a toddler. Others leave out the weight or use an old one. Many write return precautions such as call if worse. Few say who gave the history. The child's own signs, such as play and tears, are often missing. Name the historian, weigh the child, record what the child shows without words, calculate every dose from today's weight and give precautions a parent can count. If your patient's illness differs, share the history and findings, and we can draft a sample note in this format. Compare today's weight with the last visit.
Get a NR 602 Week 6 example written to your instructions
Send the Week 6 case and whichever note template your classroom supplies, and a custom example is written into that template and returned inside 24 to 48 hours. The first one is free. Tell us the child's age and the presenting complaint and the example is built around them.
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NR 602 Week 6 questions, answered
How do I handle review of systems for a young child?
Convert it into what a caregiver can observe. Eating, drinking, wet diapers, stools, sleep, activity and breathing effort are all answerable by a parent and all clinically useful. Standard adult phrasing attributed to a preschooler is one of the fastest ways to lose credibility in this note, and markers notice it immediately.
What if the parent and the findings disagree?
Record both and say which is which. A parent describing a child who has not eaten in two days, next to a child who takes a drink happily in the room, is information rather than a contradiction to resolve. The note keeps the two sources visible and the assessment explains how the discrepancy was weighed.
Do doses need to be calculated in the note?
Where a medication is prescribed, showing the weight based calculation is usually expected and is quick to mark. It also demonstrates the reasoning the week is testing, which is that pediatric prescribing is arithmetic tied to a number recorded that day. A dose written as an adult tablet strength in a child's note is an obvious loss.
Where can I find a free NR 602 Week 6 sample paper?
The full pediatric SOAP note for a febrile 17-month-old with otitis media and mild dehydration is published on this page.
How is the amoxicillin dose worked out in the NR 602 Week 6 note?
From today's weight of 9.4 kilograms at 90 mg per kilogram per day, giving 846 mg a day, given as 5.3 mL twice daily from the 400 mg in 5 mL bottle.