Pediatric nursing
Children are not small adults. Their bodies, development, and needs differ, and families are central to their care. For study only, not clinical guidance: always follow your programme, current local protocols, and supervising clinicians.
Growth and development
Children develop through predictable stages. Erik Erikson described psychosocial stages such as trust versus mistrust in infancy and autonomy versus shame in toddlerhood; Jean Piaget described cognitive stages. Developmental milestones, such as sitting by about 6 months and walking around 12 months, help identify delays.
Communicating with children
Adapt communication to age: use simple words and play with young children, offer limited choices to toddlers, explain procedures honestly just before they happen for preschoolers, and involve school-age children and adolescents in decisions. Adolescents value privacy and should have time to speak without parents present when appropriate.
Family-centred care
Family-centred care treats families as partners: sharing information, involving them in decisions and care, and respecting their knowledge of the child. Hospitalisation can cause separation anxiety, especially in toddlers; having parents present and keeping routines helps.
Vital signs in children
Normal heart and respiratory rates are higher in infants and fall with age; for example, newborns often have heart rates around 110-160 and respiratory rates around 30-60. Blood pressure is lower in young children. Use age-appropriate reference charts and correctly sized equipment.
Pediatric medication safety
Children's doses are calculated by weight in kilograms, and errors can be tenfold. Double-check calculations, use oral syringes for liquids, and verify that the dose is within the safe range. Children can deteriorate quickly; for example, dehydration develops faster than in adults.
Common pediatric conditions
Respiratory infections such as bronchiolitis (often caused by RSV) are common in infants, causing breathing difficulty and feeding problems. Gastroenteritis can lead to dehydration; oral rehydration solutions are often first-line. Fever in very young infants, especially under about 3 months, needs prompt medical evaluation.
Immunisations
Childhood vaccination schedules protect against diseases such as measles, whooping cough, polio, and Haemophilus influenzae type b. Nurses give vaccines, check schedules, address parents' concerns with accurate information, and report side effects. High coverage protects children too young or unable to be vaccinated.
Worked example
A 6-month-old has had vomiting and diarrhoea for a day, with fewer wet nappies, a dry mouth, and a sunken fontanelle. These suggest dehydration. The nurse weighs the baby, reports findings, assesses heart rate and capillary refill, and anticipates oral rehydration in small frequent amounts or IV fluids if severe, while teaching parents warning signs.
Key takeaways
Children develop through predictable stages and milestones. Communicate according to developmental stage and give adolescents privacy. Family-centred care treats families as partners. Children's vital signs differ from adults'. Pediatric doses are weight-based and need double checks. Bronchiolitis, gastroenteritis, and dehydration are common; fever in young infants needs evaluation. Immunisations protect individuals and communities.
Flashcard
Trust versus mistrust
Check your understanding
Which sign suggests dehydration in a 6-month-old infant?