Paediatric nursing: development, emergencies & weight-based dosing

Broad motor and social milestones the exam expects (averages, with normal variation):

• •INFANT (birth–1 year) — social smile by ~2 months; head control by ~4 months; sits unsupported by ~6–8 months; transfers objects and develops stranger anxiety by ~6–9 months; crawls, pulls to stand and uses a pincer grasp by ~9–12 months; birth weight roughly DOUBLES by ~5–6 months and TRIPLES by ~12 months. Erikson's task is TRUST vs mistrust — met by consistent, prompt comfort and feeding.
• •TODDLER (1–3 years) — walks well and climbs; runs by ~2 years; feeds self and uses a spoon; a large jump in vocabulary; NEGATIVISM ('no!') and temper tantrums are normal. Erikson: AUTONOMY vs shame/doubt — support with simple choices and routines. Play is PARALLEL (alongside, not with, other children).
• •PRESCHOOL (3–5 years) — hops, throws, draws simple shapes, dresses with little help; MAGICAL thinking and fear of bodily harm/mutilation are typical. Erikson: INITIATIVE vs guilt. Play is ASSOCIATIVE/cooperative and imaginative.
• •SCHOOL-AGE (6–12 years) — logical thinking, mastery of skills, strong peer and rule orientation. Erikson: INDUSTRY vs inferiority. They want to understand their care and value privacy and competence.
• •ADOLESCENT (12–18 years) — abstract thinking; body image and peer acceptance are central. Erikson: IDENTITY vs role confusion. They need honesty, confidentiality, involvement in decisions and respect for privacy.

Turning development into nursing action (frequently tested):

• •Meet the child at their stage — comfort an infant promptly and keep the primary caregiver present to ease separation anxiety; give a toddler simple choices and allow security objects; let a preschooler handle safe equipment and use simple, concrete words to counter magical thinking and mutilation fears; explain procedures to a school-age child and respect their competence; give an adolescent honesty, privacy and a say in decisions.
• •Prepare for procedures age-appropriately — perform the most FRIGHTENING or painful assessments (throat, ears, invasive steps) LAST in a young child; keep the caregiver close; use developmentally suitable language and timing (immediately before for toddlers, more notice for older children); and use distraction and play (therapeutic play) to reduce fear.
• •Atraumatic care — minimise separation, loss of control and bodily harm; involve parents; and manage pain proactively rather than assuming young children 'won't remember'.