Common Pediatric Conditions

Quick Answer: Pediatric condition items on the SNLE pair classic symptom clusters with first-line nursing actions — dehydration assessment, asthma escalation, and meningitis isolation are perennial favorites.

Common pediatric illnesses constitute a substantial share of maternal-child SNLE items. Nurses must distinguish benign self-limited illness from decompensation requiring escalation, while respecting family-centered care norms common in Saudi hospitals.

Respiratory Conditions

Bronchiolitis (RSV): infants, wheezing, tachypnea, nasal flaring, poor feeding. Supportive care: nasal suction, hydration, O₂ if hypoxemic. Ribavirin/isolation policies vary — contact precautions for RSV on many units.

Asthma: wheezing, cough, prolonged expiration. Mild: bronchodilator (salbutamol) via MDI/spacer. Moderate-severe: repeated bronchodilator, systemic steroids, O₂, peak flow if age-appropriate. Status asthmaticus — silent chest, exhaustion, dropping SpO₂ — emergency.

Croup: barking cough, stridor, hoarseness. Mild: cool mist, comfort; severe: nebulized epinephrine and steroids, airway monitoring.

Epiglottitis (less common post-Hib vaccine): drooling, tripod position, no cough — do not examine throat; prepare airway in OR. Foreign body aspiration: sudden choking, unilateral wheeze — back blows/chest thrusts by age.

Gastrointestinal

Gastroenteritis: assess dehydration using capillary refill, mucous membranes, tears, urine output, fontanelle, skin turgor. Isotonic oral rehydration solution (ORS) for mild-moderate; IV for severe or shock.

Intussusception: intermittent severe colicky pain, currant jelly stool, sausage-shaped mass — surgical/air enema urgency.

Pyloric stenosis: 2–8 week projectile nonbilious vomiting, olive mass, hypochloremic metabolic alkalosis — surgical pyloromyotomy.

Hirschsprung disease: delayed meconium, distension, ribbon stool — contrast enema and biopsy.

Febrile Illness and Sepsis

Fever in infant <3 months (especially <28 days) is emergency — full sepsis workup and empiric antibiotics. Meningitis: fever, headache, neck stiffness, photophobia, petechial rash (meningococcemia) — droplet isolation, rapid antibiotics, avoid delaying for CT if unstable.

Kawasaki disease: fever ≥5 days, conjunctivitis, strawberry tongue, rash, cervical lymphadenopathy — IV immunoglobulin and aspirin per cardiology protocol; coronary aneurysm risk.

Diabetes Type 1

Polyuria, polydipsia, weight loss, DKA presentation: Kussmaul respirations, fruity breath, dehydration. Insulin and fluids per protocol; never stop insulin during illness without endocrine plan. Monitor potassium closely during rehydration — insulin drives K+ intracellularly.

Sickle Cell Disease

Pain crisis, fever (treat as infection until proven otherwise), splenic sequestration (sudden anemia, enlarged spleen), stroke risk. Hydration, pain management, O₂ if hypoxemic. Relevant in Saudi Arabia due to regional prevalence in certain populations — know general sickle cell nursing principles.

Rheumatic Fever and Carditis

Follows untreated group A strep pharyngitis — migratory polyarthritis, carditis, chorea, subcutaneous nodules, erythema marginatum. Penicillin prophylaxis and activity restriction per carditis severity.

Urinary Tract Infection

UTI in infants may present as fever without focal signs — clean-catch or catheter specimen. Encourage fluids; complete antibiotic course. Vesicoureteral reflux workup follows recurrent UTIs in young children.

Atopic Dermatitis and Allergy

Dry skin care, emollients, trigger avoidance. Anaphylaxis: epinephrine IM first, then airway, antihistamines, steroids; observation for biphasic reaction. Teach auto-injector technique to school-age children and caregivers.

Febrile Seizures

Simple febrile seizure — generalized, <15 minutes, once in 24 hours — reassure parents, treat fever, evaluate source. Complex features or focal signs need neurology workup. SNLE distinguishes from meningitis (meningeal signs, petechiae).

Worked Scenario

A 7-month-old with 2 days watery stools, sunken fontanelle, dry mucous membranes, cap refill 4 seconds, still taking ORS. Priority: continue ORS small frequent volumes, monitor urine, IV access if worsening — antibiotics are not routine for uncomplicated viral gastroenteritis.

SNLE Traps

• Giving aspirin to children with viral illness (Reye syndrome)
• Throat exam in suspected epiglottitis
• Under-treating asthma with only one bronchodilator dose when distress persists
• Missing non-accidental trauma in unexplained injuries at varying healing stages
• Withholding ORS when infant is still drinking because IV seems faster

Otitis Media and Respiratory Syncytial Season

Acute otitis media presents with ear tugging, fever, irritability, and bulging tympanic membrane on otoscopy. Amoxicillin first-line per guidelines unless penicillin allergy — complete full course. Teach fever management with weight-based acetaminophen, never aspirin.

Pertussis causes paroxysmal cough with inspiratory whoop — droplet precautions, macrolide antibiotics, and monitor infants for apnea. Tuberculosis exposure in endemic regions requires contact tracing and prophylactic isoniazid per public health protocol — relevant in Saudi multinational populations.

Burns and Poisoning

Thermal burns: cool running water, cover with clean dressing, calculate fluid resuscitation per burn percentage in severe cases. Poison ingestion — do not induce vomiting; call poison control, administer activated charcoal per order for certain substances within time window.

Nephrotic Syndrome and Henoch-Schönlein Purpura

Nephrotic syndrome — periorbital edema, proteinuria, hypoalbuminemia — monitor fluid balance, infection risk (immunocompromised from protein loss), and edema care. HSP presents with palpable purpura on buttocks and legs, abdominal pain, joint swelling — monitor renal function and blood pressure.

Cystic Fibrosis Basics

Chronic productive cough, failure to thrive, salty skin — chest physiotherapy, pancreatic enzymes with meals, and infection prevention. SNLE may test aerosolized bronchodilator before chest PT and high-calorie diet.