Child and Adolescent Health Nursing
Milestones and assessment
Growth and development items test whether you know the norm for an age: the anterior fontanelle closes by about 18 months; head control by 4 months; sitting unsupported at 6–8 months; walking at 12–15 months; parallel play in toddlers and cooperative play by school age. Paediatric vital signs are age-dependent - infants may breathe 30–60 times a minute with heart rates of 100–160. Bradycardia in a child is a late, pre-arrest sign; children compensate with tachycardia and then decompensate abruptly.
High-yield clinical areas
Dehydration: sunken fontanelle, reduced wet diapers, and oral rehydration as first-line for mild to moderate losses. Respiratory: croup (barking cough, stridor, dexamethasone), epiglottitis (drooling, tripod posture - do not inspect the throat), bronchiolitis (RSV; suctioning and hydration). Congenital heart disease: cyanotic defects and tet spells managed with knee-chest position, calming, and oxygen. Immunizations follow the national schedule with age-appropriate sites and needle lengths.
Traps
Weight-based dosing: doses are in mg/kg and must fall inside a published safe range; a wild calculation usually signals a decimal error. Do not transplant adult assessment findings onto children, and remember family-centred care - the parent is part of the assessment.
Worked rule
Convert weight to kilograms first (pounds ÷ 2.2), calculate the safe range (mg/kg × kg), then compare with the ordered dose. If the order exceeds the range, hold it, clarify with the prescriber, and document.