Paediatric Nursing
Paediatric Nursing
Paediatric Nursing tests growth and development, neonatal care, immunisation, nutrition, dehydration and common childhood illnesses. Normal values and milestones differ from adults and are frequently examined.
Core rules
- Weight: birth weight doubles by about 5 months and triples by 1 year.
- Milestones: social smile at 6 weeks, head holding at 3 months, sitting without support at 6–8 months, walking at 12–15 months. Anterior fontanel closes at 12–18 months.
- ORS: low-osmolarity ORS is about 245 mOsm/L; give zinc for 14 days. Plan A at home, Plan B ORS at a clinic, Plan C IV fluids for severe dehydration.
- Neonatal resuscitation: warm, dry, stimulate and position the airway. If heart rate is below 100/min, start positive-pressure ventilation.
- Danger signs: not feeding, convulsions, lethargy, chest indrawing and grunting.
Worked example
An 8 kg child has some dehydration. Plan B uses 75 mL/kg over 4 hours: 8 × 75 = 600 mL. Reassess after 4 hours. Severe dehydration would need Plan C with Ringer's lactate 100 mL/kg, not oral ORS.
Traps
- Infant respiratory rate is higher than adult - about 30–60/min in newborns.
- Do not give honey to infants under 1 year because of botulism risk.
- ORS is not a substitute for IV fluids in severe dehydration or shock.