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Pediatric

Pediatric Nursing Review

Educational Use Only. This app is not intended to replace instructor guidance, institutional policies, clinical judgment, or professional medical training.

Overview

Pediatric nursing covers care from infancy through adolescence. NCLEX focuses on growth and development, immunizations, common childhood illnesses, and family-centered care. Age-appropriate communication and safety are key.

Key Concepts

  • 1

    Developmental milestones: 2 mo (social smile, holds head up), 6 mo (sits, babbles), 12 mo (walks, says words), 2 yr (runs, 2-word sentences), 4 yr (hops, tells stories)

  • 2

    Erikson's stages: trust vs mistrust (0-1), autonomy vs shame (1-3), initiative vs guilt (3-6), industry vs inferiority (6-12)

  • 3

    Immunization schedule: 2, 4, 6, 12-15, 18 months, 4-6 years; flu annually after 6 months

  • 4

    Respiratory distress in children: nasal flaring, retractions, grunting, stridor, tachypnea — assess severity

  • 5

    Dehydration in children: mild (5%), moderate (10%), severe (15%); assess fontanelles, mucous membranes, capillary refill, urine output

  • 6

    Common conditions: RSV (bronchiolitis), croup (barky cough, stridor), epiglottitis (drooling, tripod position, no cough), intussusception (currant jelly stool)

  • 7

    Child abuse signs: inconsistent history, delayed seeking of care, injuries inconsistent with story, multiple injuries at different stages

Nursing Interventions

  • Assess growth and development at every visit; plot on growth charts

  • Use age-appropriate communication: play, simple language, involve parents

  • Administer immunizations per schedule; educate parents on side effects and importance

  • Assess hydration status: fontanelles, mucous membranes, skin turgor, capillary refill, urine output

  • For respiratory distress: monitor SpO2, position for comfort, administer oxygen as ordered

  • Calculate pediatric medication doses by weight (mg/kg); double-check all calculations

  • Implement safety: childproof environment, car seats, poison prevention, water safety

Critical Red Flags

  • Respiratory rate >60 in infant or >40 in child with distress — impending respiratory failure

  • Drooling with tripod sitting position — epiglottitis (do not examine throat, prepare for intubation)

  • Currant jelly stool with intermittent severe pain in infant — intussusception

  • Bulging fontanelle in quiet infant — increased ICP

  • Petechial rash with fever — possible meningococcemia (medical emergency)

  • Signs of dehydration: no tears, sunken fontanelle, no urine output, lethargy

Key Lab Values

Normal pediatric vital signs vary by age (HR higher, RR higher in infants)

Infant HR: 100-160, child HR: 70-120

Infant RR: 30-60, child RR: 20-28

Pediatric BP: 70-90 systolic (infant), 90-110 (child)

Temperature: 36.5-37.5°C (97.7-99.5°F)

Capillary refill: <2 seconds normal

Patient Teaching

  • Follow immunization schedule; keep records; report adverse reactions

  • Use age-appropriate car seats: rear-facing until 2, forward-facing until 4, booster until 4'9"

  • Childproof home: outlet covers, gates, lock chemicals and medications, secure furniture

  • Recognize respiratory distress: rapid breathing, retractions, nasal flaring — seek immediate care

  • Manage fever: acetaminophen (not aspirin — Reye syndrome risk), fluids, light clothing

  • Report signs of dehydration: no wet diapers for 6-8 hours, no tears, sunken fontanelle, lethargy

Educational Use Only — Not a substitute for professional training.