Pediatric and Child Health Nursing
Paediatric questions test whether you can triage a sick child quickly, classify illness using IMCI logic, and calculate treatment by weight rather than by age.
Danger signs
Any child with inability to drink or breastfeed, vomiting everything, convulsions, lethargy or unconsciousness, chest indrawing, stridor at rest, or severe malnutrition needs urgent referral. Count respiratory rate for one full minute: fast breathing is 50/min or more in infants 2–12 months and 40/min or more in children 12 months to 5 years.
Diarrhoea and dehydration
- Plan A (no dehydration): extra fluids and oral rehydration salts at home, continue feeding, zinc for 14 days (10 mg under 6 months, 20 mg if older).
- Plan B (some dehydration): oral rehydration salts 75 mL/kg over 4 hours under observation, then reassess.
- Plan C (severe dehydration): intravenous Ringer's lactate 100 mL/kg - 30 mL/kg in the first hour for infants under 12 months, then 70 mL/kg over 5 hours.
Worked example
A 10 kg child with diarrhoea is irritable, has sunken eyes, drinks eagerly and has a slow skin pinch. Reasoning: some dehydration, so Plan B. Volume = 75 × 10 = 750 mL over 4 hours. Show the mother how to give it by cup and spoon, reassess at 4 hours, and give zinc for 14 days plus vitamin A if malnourished.
Traps
Mixing oral rehydration salts with the wrong volume of water; giving antibiotics for routine watery diarrhoea; using aspirin in a febrile child (Reye syndrome); estimating a dose by age instead of weighing the child.