Pediatric Nursing
Core concepts
Pediatric questions test growth and development, age-specific assessment, and family-centered care. Know developmental milestones and how they change safety and communication (e.g., infants explore orally, toddlers need simple concrete explanations, adolescents need privacy). Understand pediatric vital sign norms by age, dehydration and rehydration, respiratory disorders (croup, bronchiolitis, asthma), congenital heart defects (cyanotic vs acyanotic), immunization schedules, and child abuse recognition and reporting.
Traps candidates fall for
- Applying adult norms to children: normal heart and respiratory rates are higher in infants and fall with age.
- Missing dehydration signs in infants: sunken fontanel, decreased wet diapers, poor skin turgor, lethargy.
- Confusing croup (barking cough, inspiratory stridor, steamy air) with epiglottitis (drooling, tripod position, muffled voice, high fever), which is an airway emergency and should not have the throat examined.
- Choosing a route or dose without weight-based calculation; pediatric doses are per kilogram.
- Forgetting that a child with a cyanotic heart defect may squat to relieve hypoxia.
Rule of thumb
In pediatrics, airway and breathing first, and always weigh the child before dosing. If a child has stridor, drooling, and a tripod posture, do not inspect the throat; keep the child calm and get emergency help.
Worked example
A 3-year-old presents with a barking cough, low-grade fever, and inspiratory stridor that worsens at night. This is croup. The nurse should keep the child calm, provide humidified air, position for comfort, and monitor respiratory status. Examining the throat or agitating the child risks worsening airway obstruction, and antibiotics are not indicated for viral croup.