Child Health (Paediatric) Nursing
What this domain tests
Growth and development milestones, the Universal Immunization Programme schedule, diarrhoeal dehydration and ORS, neonatal care and reflexes, protein-energy malnutrition, acute respiratory infection, congenital heart disease, and paediatric drug-dose calculation.
Core rules
- Weight milestones: birth weight doubles by about 5 months and triples by 1 year; expected weight at 1 year is roughly 3× birth weight.
- Development: social smile at 6 weeks, head control at 3 months, sitting without support at 6–8 months, walking alone at 12–15 months, two-word sentences at about 2 years.
- UIP schedule: at birth - BCG, OPV-0, hepatitis B; at 6 weeks - pentavalent-1, OPV-1, rotavirus, IPV, PCV; measles-rubella at 9–12 months.
- ORS plans: Plan A (no dehydration) - extra fluid at home after each stool, 50–100 mL for under-2s, 100–200 mL for older children; Plan B (some dehydration) - 75 mL/kg over 4 hours; Plan C (severe) - IV Ringer lactate, 100 mL/kg.
- Neonatal reflexes: Moro, rooting, sucking, palmar grasp, tonic neck; most primitive reflexes fade by 3–6 months.
- Phototherapy: expose skin, cover eyes and genitalia, monitor bilirubin and hydration; watch for bronze baby syndrome.
Worked example
A 10 kg child with some dehydration. Plan B: 75 mL/kg × 10 kg = 750 mL over 4 hours, given by cup and spoon with reassessment at 4 hours. If the child had severe dehydration with lethargy and sunken eyes, Plan C would start with 100 mL/kg IV Ringer lactate, giving 30 mL/kg in the first hour.
Traps that cost marks
- Applying adult ORS volumes to children instead of the 75 mL/kg Plan B calculation.
- Mixing up BCG (intradermal, left upper arm) with pentavalent (intramuscular, thigh).
- Confusing marasmus (weight loss, no oedema) with kwashiorkor (oedema, hair and skin changes).
- Missing that a child with severe acute malnutrition needs F-75 stabilization feed, not catch-up growth formula initially.