Pediatric Nursing
Core concepts
Pediatric nursing emphasizes growth and development, weight-based dosing, and family-centered care. Know developmental milestones and how they shape assessment and communication (infants and toddlers cannot describe pain; use behavioral scales like FLACC; older children use numeric scales). Understand pediatric assessment differences: higher respiratory rates, compensatory tachycardia, and the danger of bradycardia as a late sign of hypoxia. Master dehydration/rehydration (oral rehydration, signs of severe dehydration), respiratory conditions (asthma, croup, bronchiolitis), and communicable diseases with their isolation requirements. Immunization schedules, safe sleep (back to sleep, no loose bedding), and injury prevention (car seats, water safety, choking hazards) are high-yield.
Traps in questions
Questions test age-appropriate interventions. A classic trap is using adult vital sign ranges or adult medication doses for a child. Recognize that children decompensate quickly-hypotension is a late sign of shock, so act on early tachycardia and delayed capillary refill. Another trap: giving aspirin to a child with a viral illness (Reye syndrome risk). For croup, remember cool mist and calm approach; for epiglottitis, never inspect the throat with a tongue blade (airway spasm risk). Also know that a child with a fever and petechial rash needs urgent evaluation for meningococcemia.
Rule of thumb
Children compensate, then crash. Treat early signs (tachycardia, tachypnea, poor perfusion) aggressively before hypotension appears.
Worked example
A toddler with croup has a barking cough and stridor at rest. Correct action: keep the child calm, provide cool mist/humidified air, position for comfort, and prepare for nebulized epinephrine and steroids if severe-avoid agitating the child.