Pediatric Nursing Flashcards

A child weighing 20 kg is prescribed paracetamol 15 mg/kg every 6 hours. How many mg per dose?

Answer: 300 mg

15 mg/kg × 20 kg = 300 mg per dose. The maximum single dose for paracetamol is 1,000 mg in adults; for children, weight-based calculation applies. Always verify against maximum dose guidelines and the available concentration.

A nurse is caring for a child post-tonsillectomy. Which finding requires immediate reporting?

Answer: Frequent swallowing or vomiting fresh blood

Frequent swallowing is a sign the child is swallowing blood from post-tonsillectomy hemorrhage — a serious surgical complication. Along with vomiting fresh blood, these are red flags for secondary hemorrhage. Immediate surgical evaluation is required.

Which vaccine is contraindicated in a child who is severely immunocompromised?

Answer: MMR (measles, mumps, rubella)

MMR is a live attenuated vaccine. Live vaccines are contraindicated in severely immunocompromised individuals (e.g., receiving chemotherapy, severe combined immunodeficiency) because the attenuated virus can cause disease in the absence of a functional immune response.

A child with Type 1 diabetes becomes sweaty, pale, and tremulous before lunch. Blood glucose is 58 mg/dL. What is the most appropriate action?

Answer: Give 15 g of rapid-acting carbohydrate (e.g., 4 oz juice) and recheck in 15 minutes

The child is hypoglycemic (BG <70 mg/dL) and symptomatic. The 15-15 rule applies: 15 g fast carbohydrate, recheck after 15 minutes. Insulin should not be given until hypoglycemia is corrected. Fat slows carbohydrate absorption and is inappropriate.

What is the most appropriate nursing response when a toddler's parent asks to stay during a painful procedure?

Answer: Allow the parent to stay if they wish; presence reduces child anxiety

Family-centered care supports parental presence during procedures. Research shows parental presence reduces anxiety and distress in young children. Parents should be given the option and prepared for what they will see. Sterility concerns relate to technique, not visitor presence.

A 5-year-old is admitted with suspected appendicitis. Which assessment finding is most indicative?

Answer: Rebound tenderness at McBurney's point

Rebound tenderness (pain on release of pressure) at McBurney's point (1/3 of the way from the right ASIS to the umbilicus) is a classic sign of appendiceal peritoneal irritation. In children, abdominal guarding and anorexia are also common findings.