| Course | NUR 607 Advanced Health Assessment |
|---|---|
| Module | Module 6 |
| Paper type | Pediatric well visit history and physical write-up |
| Length | About 1,010 words, 6 pages |
| Format | APA 7 student paper |
| School | Southern New Hampshire University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NUR 607 Module 6
Adolescent Well Visit: Blood Pressure Remeasured, BMI Classified and a Confidential Interview for a 13-Year-Old Girl
[Student Name]
Southern New Hampshire University
NUR 607: Advanced Health Assessment
Module Six Pediatric Well Visit
[Instructor Name]
[Date]
The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.
Adolescent Well Visit: Blood Pressure Remeasured, BMI Classified and a Confidential Interview for a 13-Year-Old Girl
Well visits for adolescents are brief, often driven by a form, and easy to treat as routine. They are also the main opportunity to detect rising blood pressure and weight in childhood and to ask, in private, about mood, safety and risk behaviors. Two measurement problems make documentation especially important. A single oscillometric reading can overestimate blood pressure in young people, and body mass index in children must be interpreted by percentile rather than by adult cutoffs. This write-up documents a 13-year-old's well visit and shows how careful remeasurement, correct classification and a confidential interview produce a plan that is accurate and respectful.
Subjective
Reason for visit: annual well visit and middle school sports form; accompanied by her mother.
Interval history: Maya is a 13-year-old girl in eighth grade who plans to join the volleyball team. She has been well this year, with one cold. Her mother is concerned that Maya is "always tired" and snacks late at night. Menarche occurred at 12; periods are regular. No headaches, nosebleeds, chest pain or shortness of breath. She snores occasionally, according to her mother, but without pauses in breathing. Medications: none. Allergies: none. Immunizations: up to date except the second HPV dose and the MenACWY vaccine given at 11, per the state registry.
Family history: father, 45, hypertension and type 2 diabetes; maternal grandmother, stroke at 62. No early sudden cardiac death.
Diet and activity: breakfast skipped most school days; school lunch; after-school snacks of chips and soda; family dinner four nights a week. Screen time about five hours on school days. Physical education twice a week; no other regular activity. Sleep from about midnight to 6:45 a.m. on school nights.
Confidential interview, mother out of the room: Maya was told that what she says is private unless someone is at risk. Using the HEADSS framework: Home, lives with both parents and a younger brother, gets along with them; Education, B grades, some teasing about her weight on the bus; Activities, texting friends and video games; Drugs, no alcohol, vaping or other substances, though friends have tried vaping; Sexuality, not dating, no sexual activity; Suicide and mood, feels "down" some days when teased, no thoughts of self-harm. PHQ-A score 6. Safety: wears a seat belt; no firearms at home.
Objective
Growth: height 157 cm (60th percentile); weight 68 kg (above the 97th percentile); BMI 27.6 kg/m², which the CDC chart for girls her age places beyond the 95th percentile and below 120% of the 95th percentile.
Blood pressure: initial reading by oscillometric device, 132/80 mm Hg. Because the reading was high, it was repeated by auscultation after a five-minute seated rest, legs uncrossed, no talking, right arm propped on a pillow so the cuff sat level with her heart. Right mid-arm circumference was 28 cm, so an adult cuff with a 12 cm bladder width, about 43% of the circumference, was used. Two auscultated readings: 126/78 and 122/74 mm Hg, average 124/76. Pulse 76 and regular.
General: well-appearing, engaged when interviewed alone. Skin: acanthosis nigricans on the back of the neck, velvety and hyperpigmented; no striae. Head and neck: thyroid not enlarged; tonsils grade 2. Cardiovascular: regular rhythm, no murmur; femoral pulses present and equal to radial pulses. Respiratory: clear. Abdomen: soft, no hepatomegaly palpable. Musculoskeletal: full range of motion; forward bend test without asymmetry. Tanner stage 4 for breast and pubic hair development.
Assessment
Elevated blood pressure. For adolescents aged 13 and older, the 2017 AAP guideline uses fixed thresholds: elevated blood pressure is 120 to 129 systolic with diastolic below 80, and stage 1 hypertension begins at 130/80. The guideline advises confirming a high oscillometric reading by auscultation, and it defines hypertension only when high readings persist over three visits (Flynn et al., 2017). Her auscultated average of 124/76 is therefore elevated, not hypertension, and the initial machine reading is recorded but not used for classification.
Class 1 obesity, BMI at or above the 95th percentile but below 120% of the 95th percentile, with acanthosis nigricans suggesting insulin resistance and a family history of diabetes and hypertension. The 2023 AAP guideline recommends evaluating adolescents aged 10 and older with obesity for lipid abnormalities, abnormal glucose metabolism and liver disease, and offering intensive health behavior and lifestyle treatment (Hampl et al., 2023). Occasional snoring warrants monitoring for sleep-disordered breathing, which is more common with obesity and could contribute both to her tiredness and to her blood pressure. Her short school-night sleep, under seven hours, is a simpler explanation for fatigue and is addressed first.
Mild depressive symptoms related to teasing, PHQ-A 6, without suicidal ideation. The US Preventive Services Task Force recommends depression screening for adolescents aged 12 to 18 (US Preventive Services Task Force, 2022). Cleared for volleyball.
Plan
Blood pressure: lifestyle counseling today and a repeat measurement by auscultation in six months, as the guideline recommends for elevated readings, with an earlier visit if readings rise. Obesity: fasting lipid panel, hemoglobin A1c and ALT. Referral to the clinic's family-based weight management program, which meets the guideline's intensity target. Using motivational interviewing, Maya chose two goals: eating breakfast on school days and replacing after-school soda with water. Her mother agreed to keep soda out of the house. Screen time and a bedtime of 10:30 p.m. were discussed. Mood: Maya agreed to talk to the school counselor about the teasing and to tell her mother or call the clinic if her mood worsens; the PHQ-A will be repeated at the six-week weight program visit. Immunizations: second HPV dose today. The plan was discussed with Maya first and then with her mother, using the words weight and health rather than labels.
Conclusion
This visit could have ended with a hypertension label from one machine reading and a lecture about weight. Documenting the repeat auscultated readings and cuff size, classifying blood pressure and BMI with current pediatric guidelines and recording a confidential interview produced an accurate picture and a plan that Maya helped shape.
References
Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., de Ferranti, S. D., Dionne, J. M., Falkner, B., Flinn, S. K., Gidding, S. S., Goodwin, C., Leu, M. G., Powers, M. E., Rea, C., Samuels, J., Simasek, M., Thaker, V. V., & Urbina, E. M. (2017). Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics, 140(3), Article e20171904. https://doi.org/10.1542/peds.2017-1904
Hampl, S. E., Hassink, S. G., Skinner, A. C., Armstrong, S. C., Barlow, S. E., Bolling, C. F., Avila Edwards, K. C., Eneli, I., Hamre, R., Joseph, M. M., Lunsford, D., Mendonca, E., Michalsky, M. P., Mirza, N., Ochoa, E. R., Sharifi, M., Staiano, A. E., Weedn, A. E., Flinn, S. K., . . . Okechukwu, K. (2023). Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics, 151(2), Article e2022060640. https://doi.org/10.1542/peds.2022-060640
US Preventive Services Task Force. (2022). Screening for depression and suicide risk in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA, 328(15), 1534-1542. https://doi.org/10.1001/jama.2022.16946
What the NUR 607 Module 6 instructions ask for
The NUR 607 pediatric assignment usually asks for a well-child or adolescent history and physical: interval history, growth with percentiles, developmental or school progress, nutrition, activity and sleep, immunizations, a psychosocial assessment appropriate to age, a complete examination and anticipatory guidance or a plan. Some prompts specify an age group or a finding to address. Expect three to five pages in APA 7. Record growth measures with their percentiles, document blood pressure technique and cuff size whenever a reading is high and, for adolescents, show that part of the interview happened in private, since pediatric write-ups are graded on correct measurement and developmentally appropriate assessment. Plot every measure on the right chart.
How this NUR 607 Module 6 pediatric well visit example is built
This sample documents a composite 13-year-old's well visit for a sports form. The history includes diet, screen time, sleep and a family history of hypertension and diabetes, followed by a confidential HEADSS interview with a PHQ-A score of 6. The examination records height, weight and BMI with percentiles, an initial machine reading of 132/80 and two auscultated readings with a measured cuff averaging 124/76, plus acanthosis nigricans. The assessment classifies elevated blood pressure under the 2017 AAP thresholds for adolescents and class 1 obesity under the 2023 AAP guideline, and the plan orders labs, refers to a family program and records goals Maya chose herself, with the confidential portion kept separate in the note.
Where the NUR 607 Module 6 rubric puts the points
Pediatric write-up rubrics in this course commonly weigh the interval and psychosocial history, growth measures with percentiles, correct blood pressure technique and classification, a complete age-appropriate examination, the assessment, anticipatory guidance and documentation standards. Top-band notes classify findings with the exact guideline thresholds for the child's age, document why a reading was repeated and how, and record a confidential adolescent interview with a validated screen. Graders reward plans that follow guideline intervals, involve the young person in setting goals and use respectful language about weight. Immunization status checked against a registry is often scored as well, and so is anticipatory guidance suited to the child's age and development.
NUR 607 Module 6 help: the mistakes that cost points
Pediatric notes lose points when blood pressure is classified from a single oscillometric reading, when adult BMI categories are applied to a child, when growth is reported without percentiles or when an adolescent's psychosocial history is taken only in front of a parent. Another common gap is a plan that names obesity without the evaluation the guideline recommends. Repeat high readings by auscultation with a measured cuff, use percentiles and the right age thresholds, interview adolescents alone for part of the visit and follow guideline intervals. If your case is an infant, a toddler or a school-age child with a different concern, send the scenario and template for a note built for that age.
Get NUR 607 Module 6 written to your instructions
Send the pediatric scenario, the child's age and your template. A well visit write-up with percentiles, correct blood pressure technique and classification, an age-appropriate psychosocial assessment and a guideline-based plan will reach you within 24 to 48 hours, and your first one is on the house. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
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NUR 607 Module 6 questions, answered
Where can I find a free NUR 607 Module 6 Pediatric Well Visit sample?
This page includes a complete adolescent well visit write-up: blood pressure remeasured by auscultation, BMI classified with the 2023 AAP guideline and a confidential HEADSS interview with a PHQ-A.
What blood pressure counts as elevated in a 13-year-old?
Under the 2017 AAP guideline, adolescents aged 13 and older use adult-style thresholds: 120 to 129 systolic with diastolic below 80 is elevated, and 130/80 or higher is stage 1 hypertension.
Why repeat a high blood pressure by auscultation in children?
Oscillometric devices can overestimate pressure in young people. The AAP guideline recommends confirming a high machine reading by auscultation with a properly sized cuff before classifying it.
How is obesity defined in children and adolescents?
A BMI at or above the 95th percentile for age and sex on CDC growth charts. Class 2 begins at 120% of the 95th percentile and class 3 at 140%.
What is the HEADSS assessment?
A structured adolescent psychosocial interview covering home, education, activities, drugs, sexuality and suicide or mood, ideally conducted with the young person alone after explaining confidentiality.