| Course | PA 534 Pediatrics |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 480 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 534 Week 1
Week 1 Discussion: Initial Post
The Character of a Two-Year-Old's Abdominal Pain Is the Item Nobody Can Supply: What Stands in for It, Watched and Counted, and Why the Answer Changes After Age Four
One Item Nobody Can Supply
The item I cannot get from E., a 24-month-old brought in with a week of crying spells and loose stools, is the character of the pain. An adult can tell me burning, cramping, stabbing or pressure, and each word moves the differential. E. offers crying, which is the same signal for hunger, fatigue, an ear infection and a cramping bowel. That is not a hard question for E. to answer; at two years it is an impossible one.
What Stands in for It
Behavior that can be watched: E. draws the knees up and stops playing for one to two minutes, then returns to play, which fits cramping that comes and goes rather than constant pain. E. does not resist being picked up or jolted, which argues against peritoneal irritation, where any movement hurts. E. pulls at no ear and does not hold the head. Things that can be counted: four crying spells yesterday, each within an hour after eating; six loose stools a day for a week; wet diapers five times a day.
Behavioral pain scales help structure this. The FLACC scale, scored 0 to 10 from face, legs, activity, cry and consolability, was developed for young children who cannot report pain in words (Merkel et al., 1997). During one spell in clinic, E. scored 5; between spells, 0.
Hard to Get Against Impossible
Some missing items are only hard to get. The timing of E.'s stools is hard but possible: the daycare logs diapers. The character of the pain is impossible at this age, and pretending otherwise, for example by recording "cramping" from a parent's guess as if E. said it, would put an invented fact in the chart.
The Year of Life, Attached
The answer changes with age. Around four years, many children can point to where it hurts and choose between a few words, and face scales with drawings become usable. At two, location is unreliable too: young children often point to the navel for pain from anywhere.
A Question With Two Defensible Answers
If E.'s crying spells follow meals and E. keeps eating well, should we treat "pain with eating" as a substitute for the missing character, or is that reading too much into crying? I can argue either way.
Reply to Nina
Nina, your infant "has a headache" according to the parent. What did the baby do that made the parent say so? I think the substitute evidence matters more than the word.
Reply to Theo
Theo, you used the parent's report of "sharp" pain in a 20-month-old. Whose word is that, and could it be replaced with something you watched or counted?
References
Merkel, S. I., Voepel-Lewis, T., Shayevitz, J. R., & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing, 23(3), 293-297.
PA 534 Week 1 instructions, in plain terms
The opening discussion of the pediatric course asks you to choose a single item of history that a young child cannot provide and to argue about it, not to list everything that is hard about seeing children. Name the item early and the age of the child it applies to. Then say what can stand in for it: behavior a clinician can watch in the room, events a parent or daycare can count, and validated observation scales built for children without language. The prompt also wants a distinction between data that is merely difficult to collect and data that cannot exist at that stage of development. Attach the limit to a year of life and say when it usually lifts. Finish with a question that classmates could reasonably answer in two ways. Two replies follow, and each should ask a classmate something specific about their own missing item rather than praise the post.
Inside the PA 534 Week 1 example
The sample commits in its first lines to pain character as the missing item for E., a toddler with a week of crying spells and diarrhea. Substitutes are then sorted into two kinds. Watched: knees drawn up for one to two minutes, a return to play between spells, no flinch when lifted, no ear pulling. Counted: four spells after meals, six loose stools a day, five wet diapers. The FLACC scale (Merkel et al., 1997) supplies a score of 5 in one spell and 0 between them. A short section separates the daycare diaper log, which is only hard to obtain, from a word for the pain, which a two-year-old cannot give, and warns against charting a parent's guess as the child's report. The age section names four years as the turning point for pointing and face scales. The open question asks whether pain with eating can stand in for character. The replies ask Nina what the infant did and Theo whose word "sharp" really was.
Where the points sit in the PA 534 Week 1 rubric
Most of the credit in this first post rides on choosing one item and keeping to it. Posts that wander across every difficulty of pediatric history, or never say which child they mean, give up the largest share. Next comes the quality of the substitutes: faculty want behavior and counts a reader could check, with a named observation tool where one exists, not adjectives. A separate portion of the grade rewards the hard-versus-impossible distinction, because it shows you know what a chart can honestly hold. Linking the limit to a developmental age, and saying when it ends, earns marks that general comments about children never do. The closing question is graded on whether it truly divides opinion. Replies are scored for asking a pointed question about the classmate's own patient. One cited source on pediatric pain observation covers the evidence requirement, and APA format with clean citations takes the last few points.
PA 534 Week 1 help from the desk
A frequent mistake is to write about a missing item that a parent could simply be asked, which makes the post about effort rather than development. Another is to fill the gap with a parent's descriptive word and treat it as the child's own report. Some drafts also forget to name an age, so the limit sounds permanent. If you are working from a different patient, such as an infant with fever or a preschooler with a limp, tell us the age and the case notes from your section, and a custom version of this post would pick the missing item for that child, list what stands in for it and attach the age at which it changes. Your replies would be written to the classmates whose posts you paste in. Tell us if your instructor requires a particular pain scale, and that tool will be the one scored in the post.
Get a PA-534 Week 1 example written to your instructions
Send the Week 1 instructions with any required elements your classroom prints, and a custom PA-534 post is written to them and returned inside 24-48h, the first one free. Include the age in your case, since the whole post turns on which year of life is being discussed.
More PA 534 papers and MPAS samples
- PA 534 Week 2: Age-specific Norms Table
- PA 534 Week 3: Informant History Write-up
- PA 534 Week 4: Growth Trajectory Analysis
- PA 534 Week 5: Milestone Screening Write-up
- PA 534 Week 6: Dose Error Analysis
- PA 534 Week 7: Immunization Schedule Rationale
- PA 534 Week 8: Adolescent Confidentiality Brief
- PA 533 Week 1: Prenatal Screening Claim Post
- PA 532 Week 1: Procedure Limits Discussion Post
- PA 531 Week 1: Headache Decision Rule Post
- PA 530 Week 1: Ankle Mechanism Discussion Post
PA 534 Week 1 questions, answered
The case gives me a talkative eight year old. Does the week still apply?
Yes, and it applies in a more interesting way. An eight year old supplies plenty and still cannot date an onset reliably or estimate how much was drunk yesterday. The post then argues about which specific items came from the child, which came from the adult, and which are guesses dressed as either.
How many sources does a first week post need?
Most classrooms ask for one or two, and placement is marked more closely than count. The useful spot is under a published figure or under the definition of a term the week introduced. Judgments about what an adult meant by a phrase are yours to defend in the paragraph, and a citation parked beside one reads as decoration.
Do replies have to disagree with the original post?
No, but they have to do something the first post did not. Taking a classmate's chosen substitute and naming a case where it would mislead counts. So does supplying the age at which their unavailable item stops being unavailable. What earns nothing is a paragraph restating their argument warmly before agreeing with it.
Where can I find a free PA 534 Week 1 sample paper?
A complete PA 534 Week 1 post about the missing character of a toddler's abdominal pain, with a FLACC score and two replies, is on this page.
Which pain scale does the PA 534 Week 1 sample use for a two-year-old?
It uses the FLACC scale, which scores face, legs, activity, cry and consolability from 0 to 10, and reports 5 during a spell and 0 between spells.