Sepsis in Pediatrics: NCLEX Priorities
Pediatric sepsis: fluid bolus 20 mL/kg, antibiotics within 1 hour, vasopressors.
Pediatric sepsis differs from adult, different vital sign norms, weight-based dosing. NCLEX tests early recognition and the 1-hour bundle.
Recognition
Fever or hypothermia, tachycardia, tachypnea, altered mental status, poor perfusion (capillary refill >3 sec, mottling), oliguria.
1-hour bundle
Cultures, broad-spectrum antibiotics within 1 hour, fluid bolus 20 mL/kg NS (repeat to 60 mL/kg if no response), lactate.
Fluid-refractory
Start vasopressors. Cold shock (low CO): epinephrine. Warm shock (high CO, low SVR): norepinephrine. Consider stress-dose steroids.
Sources to check
Meningitis (LP if stable), UTI, pneumonia, abdomen, central line if present, soft tissue.
Frequently asked
Fluid resuscitation limit?
Up to 60 mL/kg in first hour. Beyond that, vasopressors. Watch for fluid overload (crackles, hepatomegaly).
Most common sepsis source in neonates?
GBS, E. coli. Empiric ampicillin + gentamicin (or ampicillin + cefotaxime).
Quick check
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