NCLEX Deck

Pediatric

NCLEX Clinical Study Booklet · 12 cards

Contents

Croup.

Respiratory
What is Croup?
  • Viral upper airway infection (laryngotracheobronchitis).
  • Causes a barking cough and stridor.
What are the Causes / Risk Factors?
  • Viral (parainfluenza)
  • Ages 6 months–3 years
  • Fall / winter
What are the Symptoms?
  • Barking, 'seal-like' cough
  • Inspiratory stridor
  • Hoarseness
  • Low-grade fever
  • Worse at night
How is it Diagnosed?
  • Clinical
  • 'Steeple sign' on X-ray
What is the Treatment?
  • Cool mist / humidified air
  • Corticosteroids (dexamethasone)
  • Nebulized epinephrine (severe)
  • Keep the child calm; monitor airway
NCLEX TipCroup = barking cough + stridor. Cool humidified air and steroids help. Keep the child calm — crying worsens airway narrowing.
© NCLEX Deck1 / 12

Epiglottitis.

Emergency
What is Epiglottitis?
  • Inflammation/swelling of the epiglottis — an airway emergency.
  • Often bacterial (H. influenzae type b).
What are the Causes / Risk Factors?
  • Bacterial (Hib)
  • Unimmunized children
What are the Symptoms?
  • 4 D's: Drooling, Dysphagia, Dysphonia, Distressed airway
  • Tripod position
  • High fever
  • Muffled voice, NO cough
  • Anxiety, stridor
How is it Diagnosed?
  • Clinical (do NOT examine the throat)
  • Lateral neck X-ray (thumb sign)
What is the Treatment?
  • DO NOT inspect the throat or put anything in the mouth
  • Keep the child calm and upright
  • Prepare for intubation; airway equipment ready
  • IV antibiotics; Hib vaccine prevents
NCLEX TipEpiglottitis: NEVER put anything in the mouth/throat — it can trigger complete airway obstruction. Keep the child calm and ready to intubate.
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RSV / Bronchiolitis.

Respiratory
What is RSV / Bronchiolitis?
  • Viral lower respiratory infection of the bronchioles.
  • Common in infants; RSV is the main cause.
What are the Causes / Risk Factors?
  • Respiratory syncytial virus (RSV)
  • Infants <2 years
  • Winter months
What are the Symptoms?
  • Wheezing, tachypnea
  • Nasal congestion, cough
  • Retractions, nasal flaring
  • Poor feeding
  • Apnea (young infants)
How is it Diagnosed?
  • Nasal swab (RSV)
  • Clinical, pulse oximetry
What is the Treatment?
  • Supportive: O₂, suction, hydration
  • CONTACT precautions (isolate)
  • Monitor respiratory status
  • Palivizumab prophylaxis (high-risk infants)
NCLEX TipRSV bronchiolitis is treated supportively (O₂, suction, hydration) with contact precautions. Watch for apnea in young infants.
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Otitis Media.

Infection
What is Otitis Media?
  • Middle ear infection / inflammation.
  • Common in young children (short, horizontal eustachian tubes).
What are the Causes / Risk Factors?
  • Bacterial / viral (after URI)
  • Bottle-feeding while lying down
  • Daycare, smoke exposure
What are the Symptoms?
  • Ear pain (tugging at the ear)
  • Fever
  • Irritability
  • Red, bulging tympanic membrane
  • Decreased hearing
  • Drainage (if ruptured)
How is it Diagnosed?
  • Otoscopic exam (red / bulging TM)
What is the Treatment?
  • Antibiotics (amoxicillin) if bacterial
  • Pain control (acetaminophen)
  • Feed upright; avoid smoke
  • Tympanostomy tubes (recurrent)
NCLEX TipTeach parents to feed infants upright (not lying down) to reduce otitis media. Complete the full antibiotic course.
© NCLEX Deck4 / 12

Febrile Seizures.

Infection
What is Febrile Seizures?
  • Seizures triggered by a rapid rise in temperature.
  • Usually 6 months–5 years; generally benign.
What are the Causes / Risk Factors?
  • Rapid fever spike (viral illness)
  • Genetic predisposition
What are the Symptoms?
  • Generalized tonic-clonic seizure with fever
  • Brief (<15 min)
  • Postictal drowsiness
  • Usually one episode per illness
How is it Diagnosed?
  • Clinical
  • Identify fever source; rule out meningitis
What is the Treatment?
  • Protect from injury; side-lying
  • Antipyretics (acetaminophen) for comfort
  • Treat the fever source
  • Reassure parents (usually benign)
NCLEX TipFebrile seizures are usually benign. Protect the child during the seizure, treat the fever, and rule out meningitis.
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Congenital Heart Defects.

Cardiac
What is Congenital Heart Defects?
  • Structural heart abnormalities present at birth.
  • Acyanotic (L→R shunt) vs cyanotic (R→L).
What are the Causes / Risk Factors?
  • Genetic (Down syndrome)
  • Maternal infection (rubella)
  • Maternal diabetes, alcohol
What are the Symptoms?
  • Murmur
  • Cyanosis (cyanotic defects, e.g., Tetralogy of Fallot)
  • Poor feeding, failure to thrive
  • Tachypnea, fatigue
  • 'Tet spells' (squatting)
How is it Diagnosed?
  • Echocardiogram
  • Chest X-ray, ECG
  • Pulse oximetry
What is the Treatment?
  • Surgical repair (many)
  • Manage HF (digoxin, diuretics)
  • Small frequent feeds; monitor growth
  • Endocarditis prophylaxis
NCLEX TipCyanotic defects (like Tetralogy of Fallot) cause 'tet spells' — a knee-to-chest/squatting position improves blood flow to the lungs.
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Cleft Lip / Palate.

Congenital
What is Cleft Lip / Palate?
  • Congenital failure of the lip/palate to fuse.
  • Affects feeding and later speech.
What are the Causes / Risk Factors?
  • Genetic + environmental
  • Maternal smoking, folic acid deficiency
What are the Symptoms?
  • Visible lip / palate opening
  • Feeding difficulty (poor suction)
  • Risk of aspiration, otitis media
  • Speech issues (later)
How is it Diagnosed?
  • Visible at birth / prenatal ultrasound
What is the Treatment?
  • Special feeders, upright feeding, frequent burping
  • Cleft lip repair ~3 months; palate ~6–12 months
  • Post-op: protect suture line (no straws/pacifiers/hard objects); elbow restraints
  • Speech therapy
NCLEX TipAfter cleft lip repair, protect the suture line: no pacifiers, straws, or hard objects, position on the back, and use elbow restraints.
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Pyloric Stenosis.

GI
What is Pyloric Stenosis?
  • Hypertrophy of the pyloric sphincter → gastric outlet obstruction.
  • Presents ~2–8 weeks of age.
What are the Causes / Risk Factors?
  • Idiopathic
  • More common in firstborn males
What are the Symptoms?
  • PROJECTILE vomiting (non-bilious) after feeding
  • Hungry immediately after vomiting
  • Olive-shaped mass (RUQ)
  • Dehydration, weight loss
  • Metabolic alkalosis
How is it Diagnosed?
  • Ultrasound (thickened pylorus)
  • Electrolytes (hypochloremic, hypokalemic alkalosis)
What is the Treatment?
  • Correct fluids & electrolytes FIRST
  • Pyloromyotomy (surgery)
  • Post-op: small frequent feeds, upright
  • Monitor hydration
NCLEX TipPyloric stenosis = projectile vomiting + olive-shaped mass. Correct fluid & electrolyte imbalances before surgery.
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Intussusception.

Emergency
What is Intussusception?
  • Telescoping of one bowel segment into another → obstruction.
  • Usually 3 months–3 years.
What are the Causes / Risk Factors?
  • Idiopathic
  • Following a viral illness
  • Anatomic lead point
What are the Symptoms?
  • Sudden severe colicky pain (drawing knees up)
  • 'Currant jelly' stools (blood + mucus)
  • Vomiting
  • Sausage-shaped abdominal mass
  • Lethargy between episodes
How is it Diagnosed?
  • Ultrasound
  • Air / contrast enema (diagnostic & therapeutic)
What is the Treatment?
  • Air or contrast enema (may reduce it)
  • Surgery if enema fails / perforation
  • IV fluids, NPO
  • Passage of normal stool = resolution
NCLEX TipIntussusception = colicky pain + 'currant jelly' stools + sausage-shaped mass. An air/contrast enema can both diagnose and fix it.
© NCLEX Deck9 / 12

Kawasaki Disease.

Cardiac
What is Kawasaki Disease?
  • Acute systemic vasculitis in children.
  • Can cause coronary artery aneurysms.
What are the Causes / Risk Factors?
  • Unknown (possibly post-infectious / autoimmune)
  • Children <5 years
What are the Symptoms?
  • High fever >5 days
  • Bilateral conjunctivitis (no drainage)
  • Strawberry tongue, cracked lips
  • Rash
  • Swollen red hands/feet, peeling
  • Cervical lymphadenopathy
How is it Diagnosed?
  • Clinical criteria
  • Echocardiogram (coronary aneurysms)
  • ↑ESR/CRP, ↑platelets
What is the Treatment?
  • IVIG (reduces coronary complications)
  • High-dose aspirin
  • Monitor cardiac status (echo)
  • Assess for aneurysms
NCLEX TipKawasaki disease can cause coronary artery aneurysms — treat with IVIG and aspirin (a rare pediatric indication for aspirin).
© NCLEX Deck10 / 12

Cystic Fibrosis.

Congenital
What is Cystic Fibrosis?
  • Inherited disorder — thick, sticky mucus affects the lungs & pancreas.
  • Autosomal recessive.
What are the Causes / Risk Factors?
  • Autosomal recessive (CFTR gene)
  • Both parents carriers
What are the Symptoms?
  • Thick mucus → recurrent lung infections
  • Chronic cough, wheezing
  • Salty-tasting skin
  • Steatorrhea, malabsorption, failure to thrive
  • Meconium ileus (newborn)
How is it Diagnosed?
  • Sweat chloride test (elevated)
  • Genetic testing
  • Newborn screening
What is the Treatment?
  • Chest physiotherapy, airway clearance
  • Pancreatic enzymes with meals
  • High-calorie, high-protein diet; fat-soluble vitamins
  • Antibiotics for infections; hydration
NCLEX TipCystic fibrosis: give pancreatic enzymes with all meals/snacks and do airway clearance. The sweat chloride test confirms it.
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Growth, Development & Immunizations.

Development
Milestones
  • 2 mo: social smile; 4 mo: rolls; 6 mo: sits with support
  • 9 mo: crawls, pincer grasp; 12 mo: first words, walks
  • Assess for developmental delay
Safety by Age
  • Infants: aspiration, SIDS (back to sleep), falls
  • Toddlers: poisoning, drowning, burns
  • Choking hazards; car seats
Immunizations
  • Follow the CDC schedule (birth–18 years)
  • Live vaccines (MMR, varicella): avoid in immunocompromised / pregnancy
  • Educate parents; document
NCLEX TipPlace infants on their BACK to sleep to reduce SIDS risk. Know the general milestones and childproof for each age's hazards.
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