Pediatric Milestones, Safety, and Conditions: Infants to Preschool

2 months milestones

G: lifts head when prone. F: hands open slightly. L: coos. S: social smile.

4 months milestones

G: rolls front→back. F: hands to mouth, grasps toys. L: laughs. S: enjoys play with caregiver.

6 months milestones

G: rolls back→front, sits with support. F: transfers objects hand-to-hand. L: babbles consonants. S: stranger anxiety begins.

9 months milestones

G: crawls, pulls to stand. F: early pincer grasp. L: understands 'no', waves bye-bye. S: peek-a-boo (object permanence).

12 months milestones

G: cruises/walks (with one hand held or alone). F: mature pincer; bangs two cubes. L: 1-3 words, follows 1-step commands. S: separation anxiety peaks.

Solid food and teething teaching

Start solids around 4-6 mo, 1 new food every 3-5 days; no honey <12 mo. For teething: cold rings, gentle gum massage; avoid benzocaine gels.

15 months milestones

G: walks alone, stoops. F: scribbles, 2-block tower. L: ~3-10 words. S: points to needs.

18 months milestones

G: runs clumsily, throws ball. F: uses spoon (spills), turns 2-3 pages. L: ~10-50 words. S: tantrums common.

24 months milestones

G: stairs 2 feet/step, kicks ball. F: 6-7 block tower, turns pages singly. L: 2-3-word phrases, 50+ words. S: parallel play.

30 months milestones

G: jumps in place, stands on one foot briefly. F: draws vertical line. L: clearer 2-3 word sentences. S: simple pretend play.

36 months milestones

G: tricycle, stairs alternating feet. F: copies a circle, 9-10 block tower. L: 3-word sentences, ~200+ words. S: daytime toilet trained.

Toddlers vs Preschoolers cognition/play traits

Toddlers: egocentric, parallel play. Preschoolers: magical thinking/animism/centration, associative/pretend play.

Pertussis precautions

Droplet + standard; private room/cohort; mask visitors/staff.

Epiglottitis first priority

Airway—keep child calm, sit upright/tripod, prepare for intubation; no throat exam or tongue depressor.

Classic epiglottitis cues

Sudden high fever, drooling, dysphagia, tripod posture, muffled voice, inspiratory stridor, no cough.

RSV/bronchiolitis nursing actions

Droplet/contact precautions, suction PRN, humidified O₂ for hypoxemia, hydration, cluster care.

Impetigo contagiosa isolation

Contact precautions; topical/oral antibiotics; keep lesions covered.

Seizure safety first action

Side-lying recovery, clear hard objects, loosen clothing, suction/O₂ PRN; time & document.

Tonsillectomy bleeding signs

Frequent/continuous swallowing, tachycardia, bright-red emesis.

Blood transfusion reaction steps

Stop transfusion, keep IV open with NS, notify provider/blood bank; VS, save tubing.

Lumbar puncture position for a child

Lateral side-lying with knees to chest (or seated, leaning forward).

Phototherapy key nursing action

Check temperature often; protect eyes/genitals; ensure hydration; turn per protocol.

Neutropenia diet teaching

Raw/unwashed produce, deli meats/sushi; use cooked foods only.

Bicycle safety must-say line

Helmet every single ride; walk bikes through intersections.

Buck's traction safety must-do

Keep weights hanging freely; assess skin/CSMs often.

Restraints tying method

Quick-release knot to bed frame; frequent checks.

24-hr urine collection first specimen

Discard the first void, then start timing.

Enuresis alarm parent statement

'They woke and voided when the alarm went off.'

Atraumatic care for infant vaccines

Oral sucrose pacifier before injections; swaddle, distraction.

Buck's traction—safety must-do?

Keep weights hanging freely; assess skin/CSMs often.

Restraints—how to tie?

Quick-release knot to bed frame; frequent checks.

24-hr urine collection—first specimen?

Discard the first void, then start timing.

Enuresis alarm—parent statement that shows it's working?

They woke and voided when the alarm went off.

Atraumatic care for infant vaccines?

Oral sucrose pacifier before injections; swaddle, distraction.

Toddler ECG trick to reduce anxiety?

Sit on parent's lap; explain simply; allow touching leads.

Child with varicella—when return to school?

When all lesions are crusted/dry; avoid aspirin; itch control.

Poisoning prevention for toddlers (2 tips)?

Lock meds/chemicals out of reach; keep poison control handy; no syrup of ipecac.

Lead exposure—primary prevention at home?

Wet-mop/dust; hand/toy hygiene; avoid chipping paint; adequate iron/calcium.

PPE removal sequence after caring for an RSV infant?

Gloves → eye protection → gown → mask; hand hygiene (per policy).

Drowning prevention line for preschooler?

Touch supervision + four-sided fencing; life jackets.

Immunocompromised child—room assignment?

Private room; strict asepsis; restrict sick visitors/flowers; avoid raw foods.

Pertussis manifestations (expect to see)?

Paroxysmal whooping cough, post-tussive emesis, apnea in infants, low-grade fever.

Anaphylaxis first priority?

IM epinephrine immediately → airway/oxygen → IV fluids; monitor for biphasic reaction.

Pediatric HF—3 sign clusters?

Impaired myocardial function; pulmonary congestion; systemic venous congestion.

Hypoxemia signs in infants with CHD?

Cyanosis, tachypnea, poor weight gain, clubbing/polycythemia.

Priority cue to report in a newborn?

Grunting, retractions, cyanosis, temp instability, poor feeding.

Post-seizure immediate priority?

Airway & side-lying recovery; suction PRN; neuro checks; document.

Asthma discharge, moderate persistent—1-liner?

Daily ICS adherence, SABA for acute symptoms, trigger control, spacer technique, peak-flow zones.

Sleep disturbances in pediatrics—first steps?

Sleep hygiene, consistent routine, limit screens/caffeine, assess meds/anxiety.

Immediate follow-up cues (across conditions)?

Airway compromise, O₂ sat drop, neuro changes, uncontrolled pain, active bleeding.

Organ donation—priority around end-of-life?

Notify/coordinate with organ procurement organization; support informed choice.

Bicycle safety—parent must-know?

Properly fitted helmet every ride; reflectors/visible clothing; ride with traffic.

Varicella parent education—itch & isolation?

Topical antipruritics/oatmeal baths; isolate until crusted; avoid aspirin (Reye risk).

Sickle cell vaso-occlusive crisis—priority actions (pick 3)?

Opioid analgesia, hydration (IV/PO), O₂ if hypoxemic, warm packs, rest; vaccines up to date; consider hydroxyurea.

Sickle cell—neuro symptom that's an emergency?

Sudden slurred speech/weakness → stroke; activate emergency plan.

Cystic fibrosis nutrition—1-liner?

High-calorie/high-protein, pancreatic enzymes with all meals/snacks; extra salt in heat/exercise; chest PT.

Diabetes insipidus—hallmarks & treatment?

Polyuria/polydipsia; low urine SG/osm; desmopressin; strict I&O/daily weights; monitor Na⁺.

SIADH—key indicators & first steps?

Low UOP, weight gain, hyponatremia, concentrated urine; fluid restriction; seizure precautions.

Appendicitis—where is McBurney's point?

RLQ, ⅔ from umbilicus to ASIS; postop watch for fever, rigid abdomen, ↑ pain.

Oral nystatin for infant thrush—how to give?

Shake; paint all oral surfaces after feeds; continue 2-3 days after lesions clear.

Intussusception—classic cues (2)?

Sausage-shaped mass; intermittent colicky pain ± "currant jelly" stools; sudden relief can indicate reduction.

Rheumatic fever—expected finding?

Migratory polyarthritis, carditis, chorea, erythema marginatum, ↑ASO titer.

Aspirin (salicylate) toxicity—key sign?

Tinnitus ± hyperpyrexia, vomiting, confusion.

UTI—3 anticipatory items?

TMP-SMX as ordered, front-to-back wiping, photosensitivity precautions.

Nephrotic syndrome—best fluid status monitor?

Daily weights (same time/scale/clothes); edema checks.

Home oxygen—one safety pearl?

No smoking/open flames; keep away from heat; backup tank ready.

Medication math with ibuprofen liquid—what to remember?

Dose mg/kg; convert to mL from concentration; round to the tenth for syringes.