Pediatric Nursing
This domain tests growth and development, family-centered assessment, dehydration, respiratory distress, fever, immunization, and weight-based medication safety in infants and children.
Core rules
- Use age-specific vital sign ranges; normal values change rapidly in infancy and early childhood.
- A fever in an infant younger than 3 months is urgent and requires prompt evaluation for serious bacterial infection.
- Assess dehydration by weight loss, mucous membranes, tears, urine output, skin turgor, and mental status; use oral rehydration solution when appropriate.
- Bronchiolitis is usually supportive care: suction, oxygen if hypoxic, hydration, and respiratory monitoring.
- Never give aspirin to a child with a viral illness because of Reye syndrome.
- Calculate every drug dose by weight in kilograms and check the maximum dose.
- Follow the Israeli Ministry of Health immunization schedule and document vaccines accurately.
Worked example
A 4-month-old has a temperature of 38.2°C, poor feeding, and lethargy. Do not send the family home with an antipyretic alone. Perform a full assessment, check vital signs and hydration, and arrange urgent medical evaluation, including cultures and sepsis workup as indicated. Reason: young infants have immature immunity and may have serious bacterial infection with minimal focal signs.
Traps
- Applying adult vital sign ranges to children.
- Giving aspirin for a childhood febrile illness.
- Underestimating dehydration because the child is not vomiting.
- Missing respiratory distress: grunting, nasal flaring, retractions, and tachypnea.