Nursing study guide
Pediatrics
Age, size, development, family, and baseline change every assessment and intervention.
Not a small adult
Anatomy, physiology, communication, medication dosing, fluid reserve, and deterioration patterns change with age.
Family centered
Include the child and caregiver, respect expertise about baseline, and use developmentally appropriate choices.
Safety first
Use current pediatric references, measured weight in kilograms, and age-appropriate equipment and policies.
Development
Assess what the child can do today
Milestones describe how children play, learn, speak, act, and move; they are not a substitute for validated screening.
Infant
Regulation, feeding, growth, attachment, sensory response, head control, rolling, sitting, and mobility emerge over time.
Toddler + preschool
Language, autonomy, play, motor skills, toileting, and separation shape care.
School age
Concrete explanations, mastery, peers, school, privacy, and participation support coping.
Adolescent
Confidentiality boundaries, identity, risk, mental health, relationships, and transition skills matter.
Rapid assessment
Appearance, work of breathing, and circulation reveal urgency
Observe before touching when possible.
Appearance
Tone, interaction, consolability, gaze, speech or cry, and response to caregiver.
Breathing
Rate, effort, retractions, nasal flaring, grunting, sounds, position, color, and fatigue.
Circulation
Skin color and temperature, capillary refill, pulse quality, bleeding, urine output, and mental status.
Escalate
Apnea, cyanosis, severe work of breathing, poor responsiveness, seizure, shock signs, or rapid deterioration require emergency action.
Vitals + pain
Interpret measurements by age and context
Technique, equipment size, activity, fever, fear, sleep, and baseline affect findings.
Vitals
Use the facility’s current age-specific ranges and repeat unexpected values with correct technique.
Pain
Use a validated age- and communication-appropriate self-report or behavioral tool; caregiver input supplements assessment.
Reassessment
Trend behavior and function as well as the numeric score after comfort or analgesic interventions.
Fluids
Children can lose reserve quickly
Intake, output, weight, perfusion, and behavior often reveal more than one isolated sign.
| Assess | Concerning change | Connection |
|---|---|---|
| Intake | Poor feeding, vomiting, diarrhea, inability to retain fluids | Clarify duration and amount with caregiver. |
| Output | Fewer wet diapers or reduced urine | Use weight-based and age-appropriate expectations from current policy. |
| Perfusion | Cool skin, delayed refill, weak pulses, tachycardia, lethargy | Escalate before hypotension; it may be late. |
| Weight | Acute loss or rapid change | Use the same scale when possible; kilograms support dosing and fluid calculations. |
Medication safety
Calculate, check, and measure deliberately
A correct arithmetic answer can still be an unsafe pediatric dose.
Weight
Use a current measured kilogram weight; clarify whether an order uses actual, ideal, or another specified dosing weight.
Dose range
Compare the ordered dose and daily total with an authoritative pediatric reference and indication-specific maximum.
Preparation
Verify concentration, route, device, dilution, rate, compatibility, and measurable volume.
Independent checks
Follow policy for high-alert medications, infusion programming, and caregiver-supplied medicines.
Common pediatric illness
Recognize the pattern and the child who is tiring
Age, work of breathing, hydration, neurologic status, immunization history, and change from baseline determine urgency.
| Condition | Typical pattern | Nursing priorities and escalation |
|---|---|---|
| Asthma exacerbation | Wheeze, cough, prolonged expiration, chest tightness, reduced air movement | Assess severity and response to ordered bronchodilator therapy; silent chest, fatigue, cyanosis, altered status, or poor response is an emergency. |
| Croup | Barking cough, hoarseness, inspiratory stridor, often worse at night | Keep the child calm, assess stridor at rest and retractions, give ordered therapy; drooling, toxic appearance, severe distress, or exhaustion needs urgent escalation. |
| RSV / bronchiolitis | Rhinorrhea, cough, wheeze or crackles, tachypnea, feeding difficulty, apnea risk in young infants | Support airway clearance, oxygenation, hydration, and feeding safety; escalate apnea, cyanosis, severe work, dehydration, or fatigue. |
| Common infections | Otitis, pharyngitis, viral exanthem, gastroenteritis, and vaccine-preventable illness vary by age and exposure | Use focused assessment, hydration and fever comfort, precautions, testing/treatment plan, and return precautions; antibiotics do not treat viral illness. |
| Febrile seizure | Seizure associated with fever in the typical age range after other causes are assessed | Protect from injury, position for airway, time the event, and do not restrain or place objects in the mouth; prolonged, focal, repeated, first, or concerning recovery requires emergency evaluation. |
Communication
Prepare the child and caregiver honestly
Use simple language and preserve control where safe.
Explain
Describe what the child will see, feel, hear, and need to do without promising that nothing will hurt.
Offer choices
Let the child choose between safe options such as position, distraction, or which arm is assessed.
Partner
Ask caregivers about baseline, comfort, routines, communication, culture, and what has worked before.
Safety + protection
Development changes the hazard
Injury prevention, safeguarding, and privacy are part of every encounter.
Environment
Use age-, size-, and ability-appropriate sleep, transport, fall, choking, drowning, poisoning, and equipment precautions.
Safeguarding
Document objective findings and follow mandatory-reporting and facility procedures for suspected abuse or neglect.
Adolescents
Explain confidentiality and its safety limits; screen privately when appropriate and permitted.
Sources
Reference notes
Current pediatric references and local policy control ranges, doses, and emergency care.