The Hydration Hut
What are 3 signs of severe dehydration in infants?
Sunken fontanel
Very dry mucous membranes
No tears when crying
Sunken eyes
Poor skin turgor (tenting)
Tachycardia → weak, thready pulse
Cold, mottled extremities
Capillary refill > 4 seconds
Minimal to no urine output (oliguria/anuria)
Lethargy or decreased responsiveness
Teach a parent one safe way to use essential oils for relaxation in children.
1. Diffuse lavender or chamomile for school-age children and older
2. Never ingest
3. Avoid direct application to infants
4. Avoid placing near airway of anyone with asthma/resp issues
A 12-month-old is due for which immunizations?
MMR
Varicella
Hepatitis A (1st dose)
PCV13 (4th dose)
Hib final dose
List two signs of epiglottitis
Drooling
Tripod position
Stridor
Sudden high fever
A child is starting prednisone. What is one essential teaching point?
Do not stop abruptly
Risk for infection
Mood changes
Weight gain
Monitor BP & glucose
What finding after cast placement should be reported immediately?
Pain unrelieved by meds
Numbness
Pallor
Cold digits
Decreased pulses
Compartment syndrome signs
When would you likely see an order for IV Rehydration Therapy instead of Oral Rehydration therapy?
It will depend on the severity of dehydration. Severe dehydration will require IV rehydration therapy.
Name three priorities when caring for a child in a halo vest traction device.
Keep wrench taped to vest at all times
Pin site care daily
Skin checks under vest
Align body; fall precautions
Never loosen screws
Sponge baths only
Create a short script explaining diabetes self-management to a teenager newly diagnosed with type 1 DM
Insulin administration
Carb counting
Ketone testing
Exercise effects on glucose
Recognizing hypo/hyperglycemia
After cardiac catheterization, how should the extremity be positioned?
Maintain straight leg
Monitor pulses distal to site
Watch for bleeding/hematoma
Increase fluids
How do you safely give an oral med to a preschooler?
Teach a parent how to prevent UTIs in toddlers
Encourage regular bathroom breaks
Teach proper wiping
Keep hydration up
Choose cotton underwear
Avoid bubble baths and scented soaps
Make sure the bladder empties completely
Treat constipation
Change diapers promptly
Increase fluids during illness
A 4-year-old has watery diarrhea and sunken eyes. What is your priority nursing action?
Initiate oral rehydration therapy (ORS) immediately
Role-play teaching a parent of a toddler with celiac disease what foods to avoid.
Avoid: Wheat, rye, barley
Allow: Rice, potatoes, corn, gluten-free oats
Teaching: Lifelong gluten-free diet
Which HR requires holding digoxin for a toddler?
Hold dose if HR < 90 bpm
Signs of toxicity: vomiting, bradycardia
What are some Nutritional Facts that you can suggest to the parents/guardians of an infant with heart Failure?
Nutrition, infant with HF:
High calorie formula
Small, frequent feeds
Possible NG feeds
Name one serious adverse effect of morphine in children
Respiratory depression
Constipation
Sedation
What is an expected vs. concerning finding in a newborn receiving phototherapy?
Loose stools
Increased insensible loss
What are the dehydration manifestations in an adolescent?
Intense thirst
Dry mucous membranes
Headache
Orthostatic hypotension
Weakness
Decreased skin turgor (more reliable than in infants)
Concentrated urine
Tachycardia
Dizziness or syncope
Describe normal vs. abnormal respiratory findings in a 3-year-old.
Normal:
Belly breathing
RR 20–25 breaths/min
Abnormal:
Nasal flaring
Retractions
Stridor, wheezing, grunting
Tachypnea >30/min
Which findings indicate sickle cell crisis is a priority emergency?
Chest pain
Neurologic changes
Severe abdominal pain
Fever
A toddler swallowed a coin and is drooling. What is your FIRST action?
Drooling + difficulty swallowing = Emergency
Keep NPO
Notify provider immediately
When does a pediatric patient require referral to the interprofessional team?
PT → mobility
OT → fine motor, daily living
SLP → communication/swallowing
RT → airway clearance (CF)
Name one way that you will know if the treatment plan for Enuresis is working.
Dry nights
Decreased nighttime waking
Fewer bedwetting episodes
A toddler with fever refuses fluids. What parent teaching prevents dehydration?
Offer small sips of liquid often (every 5–10 minutes)
Use oral rehydration solutions (Pedialyte)
Avoid juice, soda, sports drinks (can worsen diarrhea)
Offer popsicles or flavored ORS ice chips
Monitor wet diapers (at least every 6–8 hours)
Call provider if signs worsen:
dry mouth
no tears
sunken eyes
no urine >8 hours
lethargy
Explain the role of pancreatic enzymes in cystic fibrosis.
CF causes thick, sticky mucus that blocks pancreatic ducts
The pancreas normally releases digestive enzymes into the small intestine.
In CF, mucus blocks these ducts, preventing enzymes from reaching the gut.
Without enzymes, food cannot be broken down properly
Children with CF cannot digest:
Fats
Proteins
Some carbohydrates
List one reportable finding for a 4-month-old.
No head control
Which findings require emergency action in epiglottitis?
Do NOT examine throat
Call rapid response
Prepare for airway support
Keep child calm
What are 3 adverse effects of Cefazolin?
Allergy (especially PCN cross-sensitivity)
Rash
GI upset
Differentiate between nephrotic syndrome & acute post-strep glomerulonephritis findings.
Nephrotic Syndrome:
The child gets very puffy, especially around the eyes, belly, and legs.
There is a lot of protein in the urine.
Pee may look foamy or bubbly.
The child may gain weight from extra fluid.
Blood pressure is usually normal.
It does not usually happen after an infection.
Acute Post-Strep Glomerulonephritis (APSGN):
Happens after a strep infection, like strep throat.
The child may have swelling, mostly around the eyes.
Pee may look tea-colored, brown, or dark from blood.
Blood pressure is often high.
The child might have a headache, feel tired, or have fever.
A good way to remember the difference:
Nephrotic = lots of protein + big swelling + foamy pee.
APSGN = blood in pee + swelling + happens after strep.