Paediatric Nursing
Paediatric Nursing tests growth and development, immunisation, fluid and nutrition needs, and recognition of the deteriorating child. Children are not small adults: normal values and drug doses change with age and weight.
Growth and development
Weight doubles by 5 months and triples by 1 year; birth weight is regained by 10–14 days. Head circumference is about 35 cm at birth and grows fastest in the first year. Social smile at 6 weeks, head control at 3 months, sitting without support at 6–8 months and walking at 12–15 months are classic milestones.
Immunisation in India
At birth: BCG, OPV zero dose, hepatitis B. At 6, 10 and 14 weeks: pentavalent, OPV, rotavirus, pneumococcal conjugate and fractional IPV. At 9–12 months: measles–rubella, Japanese encephalitis where indicated, vitamin A. At 16–24 months: DPT and MR boosters. DPT booster 2 is given at 5–6 years.
Fluids and nutrition
Exclusive breastfeeding for 6 months, complementary feeding from 6 months. For some dehydration, ORS is 75 mL/kg over 4 hours; for severe dehydration, IV Ringer lactate 100 mL/kg. Zinc is given for 14 days in diarrhoea.
Worked example
A 10 kg child with some dehydration needs 75 × 10 = 750 mL of ORS over 4 hours, about 190 mL per hour, given by spoon or cup in small frequent amounts. Reassess after 4 hours; if hydration has improved, continue ORS after each loose stool.
Traps
Aspirin is avoided in children with fever because of Reye syndrome. Infant respiratory rates are higher than adult rates. Never use adult fixed doses; calculate per kilogram and check the maximum.