Pediatric Nursing
Paediatrics tests your ability to translate adult knowledge into developmentally appropriate care. Key concepts: growth and development milestones, weight-based dosing, fluid balance, and family-centred care.
Assessment: Children compensate well and then decompensate suddenly. Early shock signs include tachycardia, cool extremities and prolonged capillary refill; hypotension is a late and ominous sign. Use paediatric early-warning tools. Pain scales are age-specific (FLACC for infants/toddlers, Wong-Baker faces or numeric scale for older children).
Respiratory: Most paediatric emergencies are respiratory. Recognize croup (barking cough, stridor) versus epiglottitis (drooling, tripod position - do not examine the throat) versus bronchiolitis (wheezing, retractions). Position of comfort and minimal handling matter.
Fluids and medications: Calculate by weight (mg/kg, mL/kg). Verify safe dose ranges; a calculated dose outside the range is a red flag requiring clarification. Oral rehydration is preferred for mild-moderate dehydration; know signs of severe dehydration (lethargy, sunken eyes, no tears).
Safety and family: Injury prevention, immunisation schedules, and recognising child safeguarding concerns (inconsistent history, injuries in non-mobile infants) are frequently tested. Always involve the caregiver in care and education.
Traps
- Applying adult normal ranges or adult doses to children.
- Waiting for hypotension before acting on shock.
- Examining the throat in suspected epiglottitis.
- Choosing a painful procedure when a less invasive option exists.
Rule of thumb
In paediatrics, respiratory distress and dehydration are the highest-yield emergencies; assess work of breathing and perfusion first, and always double-check weight-based doses.