Pediatric NCLEX Disorders & Medications
Pediatric Disorders
Disorder Pathophysiolo Risk Manifestatio Diagnostic Treatment / Medications
gy Factors ns Tests Nursing & Side Effects
Interventions
Respiratory Viral infection Prematuri Wheezing Nasal swab Contact Ribavirin
Syncytial causes ty for RSV precautions (aerosol):
Virus (RSV) inflammation Coughing antigen antiviral →
/ and mucus exposure humidified eye irritation,
Bronchiolitis plugging in to smoke chest X-ray. oxygen cough.
nasal flaring
small airways.
daycare suction Palivizumab:
retractions
monthly
injection for
< 2 years poor elevate head
prevention →
old. feeding. injection-site
encourage pain.
fluids.
Cystic Genetic defect Both Chronic Sweat Chest Pancrelipase:
Fibrosis → thick parents cough chloride test physiotherapy replaces
mucus in carriers of (> 60 mEq/L enzymes →
lungs, CF gene. Wheezing = positive). pancreatic cramps,
pancreas, and enzyme diarrhea.
GI tract. replacement
fatty stools
Albuterol &
high-calorie / Dornase alfa:
poor weight
high-protein loosen
gain
diet secretions →
tremor, throat
salty skin. irritation.
fat-soluble
vitamins (A D
E K).
Asthma Inflammation Allergies, Wheezing Peak-flow Administer Albuterol:
and meter oxygen bronchodilator
constriction of viral Cough → tachycardia,
bronchioles. infections pulmonary upright tremor.
prolonged function test. position
smoke, exhalation Fluticasone:
exercise. teach trigger inhaled steroid
avoidance → oral thrush
chest
(rinse mouth).
tightness.
monitor with
peak-flow
chart.
Otitis Media Middle-ear Bottle- Ear pain Otoscopic Warm Amoxicillin:
infection due feeding exam (red, compresses antibiotic →
to blocked fever, bulging rash, diarrhea.
Eustachian Daycare eardrum). upright
tube. feeding Acetaminophe
tugging ear
smoke n: for pain →
exposure hepatotoxic if
overdosed.
pacifier irritability possible
use. tympanostom
poor y tubes.
appetite.
Rheumatic Autoimmune Recent Fever Throat culture Bed rest Penicillin:
Fever reaction after strep eradicates
untreated infection. joint pain ↑ ASO titer monitor heart bacteria →
Group A strep allergic
throat. reactions
rash ECG. treat strep.
Aspirin:
chorea
controls
(involuntary
inflammation
movements)
→ bleeding
risk.
heart
murmur.
Kawasaki Inflammation < 5 years High fever > Clinical IV IV
Disease of blood 5 days findings immunoglobu Immunoglobu
vessels → Boys lin and aspirin lin (IVIG):
coronary red eyes may cause
artery damage. echocardiogra monitor heart chills or rash;
viral
m. rhythm monitor for
trigger. strawberry
allergy.
tongue
daily
temperature. Aspirin: fever
rash
control →
bleeding risk.
swollen
hands/feet
peeling skin.
Dehydration Fluid loss Viral Dry mucous Electrolytes Oral Oral
/ from vomiting infection membranes rehydration rehydration
Gastroenteri or diarrhea. (rotavirus stool test. (solution) salts: replace
tis ) sunken fluids →
fontanelle monitor I&O monitor for
poor overhydration.
intake. no tears avoid sugary
drinks. Ondansetron:
anti-nausea →
low urine
headache,
output.
constipation.
Intussuscepti Bowel Male Sudden pain Ultrasound Air/barium IV fluids +
on telescopes into infants < (target sign). enema (may analgesics:
itself causing 2 years Crying reduce) stabilize before
obstruction procedure.
and ischemia. cystic possible
Vomiting
fibrosis. surgery
currant-jelly
stools monitor stool
output.
palpable
mass.
Congenital 4 defects → Genetic Cyanosis Echocardiogr Oxygen Prostaglandin
Heart low oxygen am E1: keeps
Defects blood to body. maternal Clubbing calm ductus open →
(Tetralogy of rubella pulse environment flushing,
Fallot) oximetry. apnea.
squat
position surgery.
alcoholis relieves
m. dyspnea.
Common Pediatric Medications
Drug Purpose / Common Side Adverse Reactions Teaching /
Pharmacodynamics Effects Nursing
Interventions
Acetaminophen Reduces fever / pain by Nausea Liver toxicity Measure carefully
acting on hypothalamus. (overdose).
mild rash. no more than 4
g/day
avoid other
acetaminophen
products.
Ibuprofen Blocks prostaglandins to Stomach pain, Gastrointestinal Give with food
reduce inflammation / nausea. bleeding, kidney
fever. injury. avoid in infants <
6 months
report dark stools.
Amoxicillin / Kill bacteria by damaging Diarrhea, rash. Anaphylaxis. Complete course
Cephalexin cell wall.
watch for rash
use probiotic or
yogurt.
Albuterol Relaxes airway muscles Tremor, fast Severe chest pain, Use for acute
→ opens bronchi. heart rate. irregular rhythm. wheezing
shake inhaler
rinse mouth.
Montelukast Prevents inflammation by Headache, Mood changes, Take once daily at
blocking leukotrienes. abdominal depression (rare). bedtime
pain.
not for acute
attacks.
Digoxin Improves heart Nausea, poor Toxicity → Check pulse (< 90
contraction & slows rate. appetite. vomiting, infant = hold)
bradycardia, vision
halos. monitor digoxin
level & potassium.
Iron supplements Replaces iron to make red Constipation, Overdose → Give with vitamin
(Ferrous sulfate) blood cells. dark stools. toxicity. C juice
use straw – stains
teeth;keep out of
reach.
Vaccines Stimulate antibody Mild fever, Anaphylaxis (rare). Give per CDC
production for immunity. redness at site. schedule
document lot
number & site
observe 15 min
post-shot.
High-Yield Pediatric NCLEX Reminders
• Always use weight-based dosing (mg / kg).
• Never give aspirin to children < 18 years → Reye’s syndrome risk.
• Double-check high-alert meds (insulin, digoxin).
• Rotate IM injection sites; use vastus lateralis in infants.
• Dehydration: assess capillary refill, tears, and urine output (should be > 1 mL/kg/hr).
• Play therapy = best stress-reduction strategy for hospitalized children.
Pediatric Drug Safety Quick Chart
Safety Category Key Rule / Nursing Point NCLEX Tip
Medication Always calculate using mg/kg for weight-based Double-check calculations with
Dosing accuracy. another nurse for high-alert
drugs (insulin, digoxin).
Route & Infants: vastus lateralis muscle for intramuscular Never mix medicine with
Administration injections.Children >3 years: ventrogluteal or essential foods (e.g., milk) — it
deltoid.Oral meds—use oral syringe for accuracy. can cause refusal later.
High-Alert Drugs Digoxin: check apical pulse (hold if <90 bpm Observe for digoxin toxicity →
infant).Insulin: double-verify with another vomiting, bradycardia, yellow
nurse.Opioids: assess respirations before giving. vision.
Fever & Pain Acetaminophen safe for all ages; Ibuprofen only if >6 Never give Aspirin → risk for
Management months old. Reye’s syndrome.
Antibiotic Safety Always complete full course; use probiotics to prevent Penicillins: watch for rash or
diarrhea. breathing issues (allergy).
Respiratory Albuterol: rescue inhaler; may cause fast heart rate or Keep inhaler and spacer clean;
Medications tremor.Fluticasone: rinse mouth to prevent thrush. track doses used.
IV / Fluid Safety Assess IV site every hour; use smallest catheter Check for infiltration —
possible. swelling, coolness, pain.
Parental Teaching Explain purpose and side effects in simple, reassuring Encourage consistent routines
terms. and reward cooperation.
Growth & Development Milestone Quick Chart
Age Range Physical Milestones Cognitive / Social NCLEX Highlight
Milestones
Infant (0–12 Rolls at 4 months, sits at 6 Stranger anxiety at 6–8 Growth doubles by 6 months,
months) months, walks by 12 months, says first words near triples by 1 year.
months. 1 year.
Toddler (1–3 Climbs stairs, throws ball, Tantrums, parallel play, 2–3 Toilet training readiness ~2
years) runs. word sentences. years.
Preschooler (3– Hops, skips, uses scissors. Imaginary play, learns right Nightmares and fears are
6 years) vs. wrong. normal.
School Age (6– Rides bike, develops fine Cooperative play, logical Dental hygiene and safety
12 years) motor skills. thinking, rules important. teaching (helmet, seatbelt).
Adolescent (12– Puberty, growth spurts, Peer identity, abstract Discuss substance use and
18 years) acne. thinking, risk-taking sexual health confidentially.
behaviors.
Pediatric NCLEX Fast Facts
• First tooth around 6 months → total teeth ≈ age in months − 6.
• Fontanelles: posterior closes by 2 months; anterior by 12–18 months.
• Car seat: rear-facing until at least age 2 or manufacturer limit.
• Pain scales: FLACC for infants; FACES for preschoolers; numeric scale for older children.
• Hospitalization: use play and family presence to reduce fear.
