PED-BC cheat sheet

Normal infant (0–12 months): HR 100–160, RR 30–60; toddler: HR 90–140, RR 22–37; school age: HR 70–120, RR 18–25.

Minimum acceptable systolic BP for ages 1–10 years = 70 + (2 × age in years); a reading below this value defines hypotension.

APGAR is scored at 1 and 5 minutes: Appearance, Pulse, Grimace, Activity, Respiration; 0–2 points each; 7–10 is normal, <7 requires ongoing reassessment.

Urine output 1–2 mL/kg/hour indicates adequate renal perfusion; output <0.5 mL/kg/hour defines oliguria.

Pain tools by age: NIPS or CRIES for neonates, FLACC for 2 months–7 years, Wong-Baker FACES for ≥3 years, 0–10 numeric scale for ≥8 years.

Capillary refill >2 seconds, mottling, cool extremities, and narrowed pulse pressure are early markers of compensated shock in children.

Anterior fontanel closes at 12–18 months; posterior fontanel closes at 6–8 weeks; a sunken fontanel suggests dehydration, a bulging fontanel suggests increased intracranial pressure.

Head circumference is plotted until 36 months; expected values are about 35 cm at birth and 43 cm at 12 months.

Weight: birth weight doubles by 5–6 months, triples by 12 months, and roughly quadruples by 2 years.

Length increases about 50% in the first year (approximately 50 cm to 75 cm); head circumference increases about 2 cm/month in the first 3 months.

Primary teeth: expected number = age in months minus 6; first tooth erupts near 6 months and all 20 primary teeth are present by about 30 months.

Erikson stages: infancy trust vs mistrust; toddler autonomy vs shame and doubt; preschool initiative vs guilt; school age industry vs inferiority; adolescent identity vs role confusion.

Piaget stages: sensorimotor 0–2 years; preoperational 2–7 years; concrete operational 7–11 years; formal operational 11 years and older.

Primitive reflexes (Moro, rooting, palmar grasp, asymmetric tonic neck) disappear by 3–4 months; Babinski persists until about 12 months.

Milestones: sits unsupported 6–8 months; walks independently 12–15 months; uses 2-word phrases and about 50 words by 2 years.

Play progression: solitary (infant), parallel (toddler), associative and cooperative (preschool), competitive rule-based games (school age).

Hepatitis B at birth, 1–2 months, and 6 months; DTaP at 2, 4, 6, 15–18 months and 4–6 years; MMR and varicella at 12–15 months and 4–6 years.

Tdap and HPV series at 11–12 years; meningococcal conjugate at 11–12 years with booster at 16 years; influenza vaccine annually from 6 months of age.

Exclusive breastfeeding for about 6 months with continuation to 12 months; breastfed infants need 400 IU vitamin D daily and 1 mg/kg/day iron from 4 months if exclusively breastfed.

SIDS risk reduction: supine for every sleep, firm flat surface, no loose bedding or soft objects, pacifier at bedtime, avoid overheating.

Car safety: rear-facing until age 2 or seat limit, then forward-facing harness, then booster until about 4 feet 9 inches (145 cm) and 8–12 years; back seat until age 13.

Newborn screening includes a hearing screen before discharge and pulse oximetry screening for critical congenital heart disease at 24 hours or later; a failed oximetry result requires echocardiography.

Lead screening at 12 and 24 months for high-risk children; fluoride supplementation from 6 months when household water contains <0.3 ppm fluoride.

BMI at or above the 85th percentile is overweight and at or above the 95th percentile is obesity for children 2 years and older, based on age and sex.

Dehydration severity: <5% mild, 5–10% moderate, >10% severe; moderate dehydration is treated with oral rehydration solution 50–100 mL/kg over 3–4 hours.

Pediatric DKA: 10–20 mL/kg isotonic fluid bolus, then insulin infusion 0.05–0.1 units/kg/hour started after fluid resuscitation; cerebral edema is the leading cause of death.

Asthma: short-acting beta agonist for rescue, daily inhaled corticosteroid for persistent disease; a silent chest or SpO2 <90% signals impending respiratory failure.

Croup: barking cough with inspiratory stridor; dexamethasone for all severities and nebulized epinephrine for moderate to severe presentations.

Epiglottitis: drooling, tripod positioning, muffled voice; do not inspect the throat or agitate the child, keep upright, and prepare for emergent airway management.

Bronchiolitis: supportive care with suctioning, oxygen, and hydration; routine bronchodilators and corticosteroids are not recommended.

Kawasaki disease: fever for 5 or more days plus conjunctivitis, mucositis, rash, extremity changes, and cervical adenopathy; IVIG plus aspirin prevents coronary artery aneurysm.

Pyloric stenosis: projectile nonbilious vomiting at 3–6 weeks with hypochloremic, hypokalemic metabolic alkalosis; correct fluid and electrolyte deficits before pyloromyotomy.

Neutropenic precautions apply when the absolute neutrophil count is <500 cells/mm3; a fever of 38.3 °C or higher requires immediate cultures and empiric antibiotics.

Consent for a minor: a parent or legal guardian signs informed consent; developmental assent is obtained from children around 7 years and older.

Mandatory reporting of suspected child abuse is based on reasonable suspicion, not proof, and good-faith reports are protected from liability.

Core ethical principles: autonomy, beneficence, nonmaleficence, justice, veracity, and fidelity.

Delegation to unlicensed assistive personnel is limited to tasks within their training; assessment, teaching, and evaluation remain the registered nurse's responsibility.

Adolescent confidentiality: many states allow minors to consent independently to sexually transmitted infection and mental health care; verify state law before disclosing to parents.

Sentinel events trigger a root cause analysis; just culture addresses system failures while distinguishing human error from reckless behavior.

Atraumatic care minimizes separation and pain, uses developmentally appropriate preparation, and confirms learning with teach-back.