Perfect — I’ll give you a pediatric-only, NCLEX-style study guide
covering every topic you listed.
I’ll keep each section high-yield: what to assess, key s/s, nursing care,
procedural steps (when applicable), priority actions, do’s / don’ts, and
NCLEX tips — exactly the format that helps you answer exam questions
quickly.
This is long — but organized so you can jump to a topic. Save/print for
study.
PEDIATRIC NURSING — HIGH-YIELD STUDY GUIDE (NCLEX STYLE)
Quick reminder on priorities for pediatrics:
1. Airway/Breathing (look for increased work of breathing)
2. Circulation / Massive hemorrhage
3. LOC/Neuro changes (ICP, seizures)
4. Fever in neutropenic or infant < 2 months
For answer choices: pick the option that fixes the most life-
threatening problem first.
RESPIRATORY
Croup (laryngotracheobronchitis)
Key s/s: Barking cough, inspiratory stridor, hoarseness, low-grade
fever, worse at night.
Assessment: Audible stridor at rest = moderate/severe. Monitor RR,
work of breathing (retractions), pulse ox.
Nursing care / interventions:
o Keep child calm (crying worsens airway).
o Humidified air / cool mist (can reduce edema).
o Racemic epinephrine for moderate-severe stridor (per order)
— observe for rebound.
o Dexamethasone single dose PO/IM/IV to reduce inflammation.
, Priority: If stridor at rest or increased work → prepare for airway
support; call provider/rapid response.
Do NOT: force tests that upset the child. Avoid sedatives that depress
respirations.
NCLEX tip: Calm environment + steroids + racemic epi for severe
cases.
Epiglottitis
Key s/s: Rapid onset, high fever, severe sore throat, drooling, muffled
voice, tripod position, severe inspiratory stridor, anxiety.
Assessment: DO NOT attempt to visualize throat with tongue
depressor (can cause airway closure).
Nursing care:
o Keep child calm and upright.
o Prepare for immediate intubation — airway can close
quickly.
o Droplet precautions until bacterial cause addressed.
Priority: Airway management → call anesthesia/ENT/rapid response.
Do NOT: inspect throat or make child cry.
NCLEX tip: Tripod + drooling + high fever = epiglottitis → airway
first.
RSV (Bronchiolitis)
Key s/s: Rhinorrhea, cough, wheeze, tachypnea, poor feeding, apnea
in infants.
Assessment: Monitor O₂ sat, hydration, respiratory effort.
Nursing care:
o Supportive: humidified O₂ if hypoxic, suction (nasal) before
feeding, hydrate, small frequent feeds.
o Monitor for apnea in neonates.
, o Contact/droplet precautions depending on facility.
Medications: Palivizumab prophylaxis for high-risk infants (preterm,
chronic lung disease, congenital heart disease) — admin prior to RSV
season.
Do NOT: give bronchodilators routinely (some improvement possible
but not standard).
NCLEX tip: Suctioning before feeds & maintaining hydration are
exam favorites.
Asthma (Pediatric)
Key s/s: Wheeze, cough (especially night/exercise), SOB, chest
tightness, prolonged expiratory phase.
Assessment: Peak expiratory flow (age-appropriate), pulse ox, work
of breathing.
Nursing care:
o Nebulized short-acting β2 agonists (albuterol) for acute
exacerbation.
o Systemic steroids for moderate/severe exacerbation.
o Maintenance: inhaled corticosteroids, spacer use for children,
allergy control.
Priority: If severe — oxygen, continuous nebulizer, prepare for
intubation.
Do NOT: withhold rescue inhaler. Teach spacer + mask for toddlers.
NCLEX tip: Spacer increases med deposition; give rescue meds first.
Cystic Fibrosis (CF) (covered twice in list — core points)
Key s/s: Chronic productive cough, recurrent respiratory infections,
failure to thrive, bulky/foul stools, salty skin.
Assessment: Pulmonary status, growth parameters, stool patterns,
glucose (CFRD), sputum cultures.
covering every topic you listed.
I’ll keep each section high-yield: what to assess, key s/s, nursing care,
procedural steps (when applicable), priority actions, do’s / don’ts, and
NCLEX tips — exactly the format that helps you answer exam questions
quickly.
This is long — but organized so you can jump to a topic. Save/print for
study.
PEDIATRIC NURSING — HIGH-YIELD STUDY GUIDE (NCLEX STYLE)
Quick reminder on priorities for pediatrics:
1. Airway/Breathing (look for increased work of breathing)
2. Circulation / Massive hemorrhage
3. LOC/Neuro changes (ICP, seizures)
4. Fever in neutropenic or infant < 2 months
For answer choices: pick the option that fixes the most life-
threatening problem first.
RESPIRATORY
Croup (laryngotracheobronchitis)
Key s/s: Barking cough, inspiratory stridor, hoarseness, low-grade
fever, worse at night.
Assessment: Audible stridor at rest = moderate/severe. Monitor RR,
work of breathing (retractions), pulse ox.
Nursing care / interventions:
o Keep child calm (crying worsens airway).
o Humidified air / cool mist (can reduce edema).
o Racemic epinephrine for moderate-severe stridor (per order)
— observe for rebound.
o Dexamethasone single dose PO/IM/IV to reduce inflammation.
, Priority: If stridor at rest or increased work → prepare for airway
support; call provider/rapid response.
Do NOT: force tests that upset the child. Avoid sedatives that depress
respirations.
NCLEX tip: Calm environment + steroids + racemic epi for severe
cases.
Epiglottitis
Key s/s: Rapid onset, high fever, severe sore throat, drooling, muffled
voice, tripod position, severe inspiratory stridor, anxiety.
Assessment: DO NOT attempt to visualize throat with tongue
depressor (can cause airway closure).
Nursing care:
o Keep child calm and upright.
o Prepare for immediate intubation — airway can close
quickly.
o Droplet precautions until bacterial cause addressed.
Priority: Airway management → call anesthesia/ENT/rapid response.
Do NOT: inspect throat or make child cry.
NCLEX tip: Tripod + drooling + high fever = epiglottitis → airway
first.
RSV (Bronchiolitis)
Key s/s: Rhinorrhea, cough, wheeze, tachypnea, poor feeding, apnea
in infants.
Assessment: Monitor O₂ sat, hydration, respiratory effort.
Nursing care:
o Supportive: humidified O₂ if hypoxic, suction (nasal) before
feeding, hydrate, small frequent feeds.
o Monitor for apnea in neonates.
, o Contact/droplet precautions depending on facility.
Medications: Palivizumab prophylaxis for high-risk infants (preterm,
chronic lung disease, congenital heart disease) — admin prior to RSV
season.
Do NOT: give bronchodilators routinely (some improvement possible
but not standard).
NCLEX tip: Suctioning before feeds & maintaining hydration are
exam favorites.
Asthma (Pediatric)
Key s/s: Wheeze, cough (especially night/exercise), SOB, chest
tightness, prolonged expiratory phase.
Assessment: Peak expiratory flow (age-appropriate), pulse ox, work
of breathing.
Nursing care:
o Nebulized short-acting β2 agonists (albuterol) for acute
exacerbation.
o Systemic steroids for moderate/severe exacerbation.
o Maintenance: inhaled corticosteroids, spacer use for children,
allergy control.
Priority: If severe — oxygen, continuous nebulizer, prepare for
intubation.
Do NOT: withhold rescue inhaler. Teach spacer + mask for toddlers.
NCLEX tip: Spacer increases med deposition; give rescue meds first.
Cystic Fibrosis (CF) (covered twice in list — core points)
Key s/s: Chronic productive cough, recurrent respiratory infections,
failure to thrive, bulky/foul stools, salty skin.
Assessment: Pulmonary status, growth parameters, stool patterns,
glucose (CFRD), sputum cultures.
