OCTC Pediatric Nursing NSG 213
Pediatric Nursing Exam 1 Review: Mastering Care for Specialized Conditions
Comprehensive guide to pediatric nursing approaches for respiratory, cardiac, neurological, and mental health disorders—essential knowledge for providing exceptional care to our youngest patients.
Why This Matters: The Unique Needs of Pediatric Patients
Children are not simply "small adults." Their developing bodies and organs require specialized nursing approaches that differ significantly from adult care. A pediatric nurse must understand the nuances of growth patterns, developmental milestones, and age-appropriate assessments.
Family-centered care becomes essential in pediatrics, as parents and caregivers are integral to successful treatment outcomes. Research shows that involving families in care decisions improves patient compliance and reduces hospitalization time.
Early recognition of pediatric disorders often presents differently than in adults. Subtle changes in vital signs or behavior may indicate serious conditions requiring immediate intervention. Pediatric nurses serve as crucial advocates for children who cannot always express their symptoms effectively.
Chapter 12 Respiratory Disorders: Breathing Easier with Expert Care
Assess and manage common pediatric respiratory conditions including asthma, bronchiolitis, pneumonia, and cystic fibrosis.
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Common Conditions
  • Asthma: chronic airway inflammation with bronchospasm
  • Bronchiolitis: viral infection affecting bronchioles
  • Croup: viral infection with "barking" cough
  • Pneumonia: lung inflammation from infection
  • Cystic Fibrosis
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Key Assessments
  • Respiratory rate (varies by age)
  • Work of breathing: retractions, nasal flaring
  • Oxygen saturation (≥95% typically normal)
  • Breath sounds: wheezing, crackles, rhonchi
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Critical Interventions
  • Airway positioning and suctioning
  • Medication administration techniques
  • Hydration maintenance
  • Family education on home management
Case Highlight: When managing a 6-year-old with acute asthma exacerbation, implement peak flow monitoring before and after nebulizer treatments to objectively assess improvement. Document respiratory effort, oxygen requirements, and response to therapy to guide ongoing treatment decisions.
Chapter 13: Cardiac Disorders - Supporting Tiny Hearts
Recognize congenital and acquired heart conditions in pediatric patients, including assessment findings and nursing interventions.
Congenital Heart Defects
  • Tetralogy of Fallot: four defects requiring surgical repair
  • Ventricular septal defect: abnormal opening between ventricles
  • Atrial septal defect: opening between atria
  • Patent ductus arteriosus: failure of fetal blood vessel to close
Acquired Conditions
  • Kawasaki disease: inflammatory condition affecting coronary arteries
  • Rheumatic heart disease: following streptococcal infection
  • Myocarditis: inflammation of heart muscle
Vital Signs Monitoring
Assess heart rate, blood pressure, and pulse oximetry. Document cardiac rhythm and perfusion. Compare to age-appropriate norms—pediatric vital signs vary significantly by age.
Medication Management
Administer cardiac medications with extreme precision. Common medications include digoxin for strengthening contractions, diuretics for fluid management, and ACE inhibitors for afterload reduction.
Post-Op Care
Monitor surgical sites for infection, maintain fluid balance, assess pain, and watch for complications. Educate parents on home care, medication administration, and activity restrictions.
Chapter 14: Neurological Disorders, Protecting the Developing Brain
Evaluate and intervene in pediatric neurological conditions including seizure disorders, traumatic brain injury, neurodevelopmental disorders, and sensory impairments.
Common Disorders
  • Seizures (febrile and epilepsy)
  • Meningitis and encephalitis
  • Cerebral palsy
  • Hydrocephalus
Neurological Assessment
  • Level of consciousness (age-appropriate)
  • Cranial nerve function
  • Motor and sensory function
  • Reflexes and developmental milestones
Nursing Priorities
  • Seizure precautions and documentation
  • Monitoring for increased intracranial pressure
  • Pain assessment using pediatric scales
  • Family education and support
Clinical Insight: Meningitis in infants may present subtly with irritability, poor feeding, or bulging fontanelle rather than classic neck stiffness. Prompt recognition and intervention are critical for preventing long-term neurological damage.
Chapter 15: Mental Health Disorders in Pediatrics - Caring for the Whole Child
Understand developmental presentations of common pediatric mental health conditions including ADHD, anxiety, depression, and autism spectrum disorders.
Mental health disorders affect up to 20% of children and adolescents, yet many go undiagnosed or untreated. Pediatric nurses play a crucial role in assessment, intervention, and coordination of care for these often invisible conditions.
Developmental Considerations
Erikson's psychosocial stages provide a framework for understanding how mental health issues may manifest differently at various ages:
  • Trust vs. Mistrust (0-18 months): Attachment disorders
  • Autonomy vs. Shame (18 months-3 years): Anxiety, behavioral issues
  • Initiative vs. Guilt (3-5 years): Phobias, separation anxiety
  • Industry vs. Inferiority (6-12 years): ADHD, learning disorders
  • Identity vs. Role Confusion (12-18 years): Depression, eating disorders
Case Study: For a school-aged child with ADHD, implement structured daily routines, establish clear behavioral expectations, and create consistent reward systems. Collaborate with parents on medication administration timing to optimize effectiveness during school hours.
Integrating Care: Holistic Approaches and Family-Centered Nursing
Family Education
Tailor teaching to family's learning style, cultural background, and health literacy level. Use teach-back method to confirm understanding. Provide written materials in preferred language with clear illustrations.
Multidisciplinary Coordination
Facilitate communication between specialists, therapists, school nurses, and primary care providers. Document care plans clearly and advocate for services when needed. Attend multidisciplinary rounds to provide nursing perspective.
Evidence-Based Practice
Apply current research-supported interventions appropriate for pediatric patients. Follow institutional protocols while individualizing care. Document outcomes to contribute to quality improvement initiatives.
Example: When teaching parents of a child with cystic fibrosis, demonstrate chest physiotherapy techniques and have them return the demonstration. Provide nutritional guidance for high-calorie, high-protein diets, and teach proper enzyme administration with meals.
Ready for Exam 1: Key Takeaways and Next Steps
Exam I Study Resources

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Chapter 12 Case Studies

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Chapter 13 Case Studies

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Chapter 15 Case Studies

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Study Tip: Focus on "Why"
Don't just memorize interventions—understand the physiological reasons behind them. This deeper understanding will help you apply knowledge to unfamiliar scenarios on the exam and in clinical practice.
Remember that pediatric nursing requires both scientific knowledge and compassionate care. Your expertise will directly impact not only the physical health of children but also their emotional well-being and future development. Approach your exam preparation with the same dedication you'll bring to your pediatric patients!