Pediatric Nursing
Pediatric Nursing tests growth and development, family-centered care, age-specific assessment, common childhood illnesses, immunizations, and safe medication dosing. The exam expects you to adapt adult knowledge to children's anatomy, communication, and family context.
Core rules and concepts
- Development. Use milestones and Erikson stages to anticipate behavior. Infants build trust; toddlers seek autonomy; preschoolers initiate play; school-age children industry; adolescents identity. Stranger anxiety is normal in infancy; toddlers may resist procedures. Explain at the child's level and support the caregiver.
- Assessment. Pediatric vital signs vary by age; infants normally breathe faster and have higher heart rates. Signs of respiratory distress include nasal flaring, grunting, retractions, and cyanosis. Dehydration signs include dry mucosa, sunken fontanel in infants, decreased urine output, and lethargy.
- Immunizations. Follow the current schedule. Live vaccines are generally avoided in immunocompromised patients and during pregnancy. Mild illness is not a reason to delay most vaccines.
- Medication safety. Doses are weight-based in kilograms. Use an oral syringe, not a household spoon. Never give aspirin to a child with a viral illness because of Reye syndrome. Avoid codeine and tramadol in young children after tonsillectomy.
- Fluids. Use the 4-2-1 rule for maintenance: 4 mL/kg/hr for the first 10 kg, 2 mL/kg/hr for the next 10 kg, and 1 mL/kg/hr for each additional kg.
Worked example
A 12-kg child needs maintenance IV fluids. First 10 kg × 4 mL/kg/hr = 40 mL/hr. Next 2 kg × 2 mL/kg/hr = 4 mL/hr. Total = 44 mL/hr. The nurse should verify the order, program the pump, and monitor intake, output, and electrolytes.
Traps that cost marks
- Using adult vital-sign ranges or adult doses for a child.
- Giving aspirin for fever in a child with chickenpox or influenza.
- Delaying vaccination for a minor runny nose.
- Forgetting to convert pounds to kilograms before calculating a dose.