Child Health and Paediatric Nursing
Paediatric nursing requires you to hold two ideas at once: children are not small adults (their anatomy, physiology, and communication needs differ), and the family is the unit of care. Master growth and development milestones and their ranges, since questions often ask whether a finding is expected for the age. Know immunisation schedules conceptually - live versus inactivated vaccines, true contraindications versus precautions, and what to do when a dose is delayed.
High-yield clinical areas include assessment of the sick child (respiratory rate, chest indrawing, ability to feed, level of consciousness, and danger signs), dehydration and diarrhoea (assess and classify, then use oral rehydration solution; zinc where protocol indicates), respiratory illness (bronchiolitis, pneumonia, asthma), fever and febrile convulsion, malnutrition (weight-for-age and weight-for-height, oedema), neonatal and infant feeding, and child safety and injury prevention.
Drug calculations are frequent and dose per kilogram, so always check weight, verify the safe dose range, and round appropriately. Communication traps include using adult explanations with children; the correct approach is age-appropriate preparation, play therapy, and involving the caregiver.
Traps: assuming a quiet, still child is well - a lethargic child may be critically ill; selecting an adult intervention that is unsafe in children (e.g., aspirin in febrile illness); ignoring caregiver teaching; and forgetting that normal ranges for pulse and respiratory rate vary with age.
Rule of thumb - treat the child, not the number: a child's clinical state (feeding, alertness, breathing effort) outweighs a single measurement. Worked example: a 2-year-old with diarrhoea is irritable, has sunken eyes, and drinks eagerly - classify as some dehydration and give oral rehydration solution, reassessing frequently, rather than immediately reaching for intravenous fluids.