小児看護英語：必須語彙とフレーズ

"Paediatric Early Warning Score"

A validated scoring system that aggregates observations of behaviour, cardiovascular status, and respiratory status in children to detect early clinical deterioration and trigger timely escalation; abbreviated PEWS

"A Paediatric Early Warning Score of 5 prompted the ward nurse to escalate immediately to the registrar, who arrived within seven minutes and initiated oxygen therapy for the child's worsening bronchiolitis."

"age-appropriate vital signs"

The normal ranges for heart rate, respiratory rate, blood pressure, and oxygen saturation that vary by developmental stage — neonate, infant, toddler, school-age, and adolescent — and must be interpreted against age-specific reference charts

"Recognising that a heart rate of 160 beats per minute is within age-appropriate vital signs for a six-week-old but represents tachycardia in a ten-year-old, the nurse used the correct reference chart before documenting the observation."

"Paediatric Assessment Triangle"

A rapid visual assessment tool that evaluates appearance (tone, interactivity, consolability, look/gaze, and speech/cry), work of breathing, and circulation to skin to categorise the severity of a child's illness before touching the patient; abbreviated PAT

"Application of the Paediatric Assessment Triangle from the doorway revealed abnormal appearance with glazed eyes and poor muscle tone, indicating the toddler required immediate intervention for altered consciousness."

"weight-based dosing"

The calculation of drug doses expressed as milligrams per kilogram of body weight to account for the wide variation in body mass across the paediatric population, requiring accurate weight measurement before any medication is prescribed or administered

"Weight-based dosing of amoxicillin at 90 mg/kg/day divided into three doses required the nurse to verify the child's current weight of 18 kg and confirm each dose of 540 mg before administration."

"developmental milestone assessment"

The systematic evaluation of a child's attainment of expected gross motor, fine motor, language, and social-emotional skills at defined age intervals to identify delays requiring early intervention

"Developmental milestone assessment during the two-year health check revealed that the child was not yet combining two words, and a referral to speech and language therapy was initiated on the same day."

"fever without source"

A febrile illness in a young child, typically under three years of age, in which no focus of infection is identified after thorough history-taking and examination, requiring risk-stratified investigation to exclude serious bacterial infection; abbreviated FWS

"The six-month-old presented with fever without source and a temperature of 39.2°C; in accordance with NICE guidance, a full septic screen including blood culture, urine culture, and lumbar puncture was performed."

"paediatric pain assessment"

The use of age-appropriate validated tools — including the FLACC scale for pre-verbal children, the Wong-Baker FACES scale for children from three years, and the numerical rating scale from adolescence — to quantify pain intensity and guide analgesia

"Using the FLACC pain assessment scale, the nurse scored the eight-month-old post-operatively at 7 out of 10 based on facial grimacing, leg drawing, and inconsolable crying, and administered the prescribed paracetamol suppository."

"head circumference measurement"

The measurement of the occipitofrontal circumference plotted on a centile chart to monitor brain growth in infants and detect macrocephaly, microcephaly, or rapidly increasing head size suggesting raised intracranial pressure

"Serial head circumference measurements showed a crossing of two centile lines upward over six weeks; together with a tense fontanelle and sunset sign, this prompted urgent cranial ultrasound to exclude hydrocephalus."

"Apgar score"

A standardised assessment of a newborn's condition at one and five minutes of life, scoring appearance (skin colour), pulse, grimace, activity (muscle tone), and respiration each from zero to two, with a total score of seven to ten indicating a well infant

"The Apgar score was 4 at one minute due to central cyanosis, weak cry, and poor tone; positive pressure ventilation was initiated and at five minutes the score had improved to 8."

"gestational age"

The age of a fetus or newborn measured in completed weeks from the first day of the mother's last menstrual period, used to classify infants as term (37–42 weeks), preterm (under 37 weeks), or post-term (over 42 weeks)

"At a gestational age of 28 weeks, the infant required surfactant therapy, continuous positive airway pressure, and parenteral nutrition while enteral feeding was gradually established over two weeks."

"kangaroo mother care"

A method of newborn care in which the infant is held skin-to-skin on the parent's chest for extended periods, promoting thermoregulation, breastfeeding, bonding, and neurodevelopmental outcomes, particularly in preterm infants; abbreviated KMC

"Kangaroo mother care was initiated at 48 hours of life for the 32-week infant; daily skin-to-skin sessions of two hours reduced the infant's apnoea episodes and supported the mother's milk supply."

"phototherapy"

The use of blue-spectrum light to break down unconjugated bilirubin in the skin of jaundiced neonates into water-soluble isomers that can be excreted without hepatic conjugation, reducing the risk of bilirubin encephalopathy

"Phototherapy was commenced at 36 hours of age when the serum bilirubin reached the treatment threshold on the gestation-specific chart; the infant's eyes were shielded and feeds were maintained to maximise bilirubin excretion."

"neonatal sepsis"

A life-threatening systemic infection occurring in the first 28 days of life, classified as early-onset (within 72 hours, typically acquired during labour or delivery) or late-onset (after 72 hours, typically healthcare-associated or community-acquired)

"Neonatal sepsis was suspected when the 10-day-old became temperature-unstable, lethargic, and feeding poorly; broad-spectrum antibiotics were commenced within one hour of blood and urine cultures being taken."

"continuous positive airway pressure"

A form of non-invasive respiratory support that delivers a constant positive pressure to the airway of a breathing infant to maintain alveolar patency and reduce the work of breathing in conditions such as respiratory distress syndrome; abbreviated CPAP

"Nasal continuous positive airway pressure at 6 cmH₂O was applied via a binasal prong interface for the preterm infant with respiratory distress syndrome, avoiding the need for intubation and mechanical ventilation."

"thermoregulation in neonates"

The maintenance of a newborn's core temperature within the normal range of 36.5 to 37.5°C using incubators, radiant warmers, warm wrapping, and skin-to-skin contact, preventing hypothermia which increases oxygen consumption, hypoglycaemia risk, and mortality

"Thermoregulation in neonates was maintained by nursing the 30-week infant in a double-walled incubator set to 35°C with added humidity, and the temperature was recorded every three hours to detect early cooling."

"orogastric feeding tube"

A thin, flexible tube passed through the mouth into the stomach to deliver expressed breast milk or formula to neonates who cannot yet coordinate the suck-swallow-breathe sequence required for oral feeding

"An orogastric feeding tube was inserted and placement confirmed by pH testing of aspirate before each feed, as the 31-week infant had not yet developed the coordination for direct breastfeeding."

"bronchiolitis"

An acute lower respiratory tract infection caused predominantly by respiratory syncytial virus that produces inflammation and oedema of the bronchioles in infants under two years of age, causing wheeze, tachypnoea, chest recession, and feeding difficulties

"The three-month-old presenting with bronchiolitis had subcostal recession, an oxygen saturation of 91% on room air, and had taken less than half of normal feeds for 24 hours, meeting criteria for hospital admission."

"inhaler technique assessment"

The systematic evaluation of a child's or carer's ability to correctly use a metered dose inhaler with a spacer, including correct actuation-inhalation coordination, breath-holding, and mouth washing to ensure adequate drug deposition in the lower airways

"Inhaler technique assessment at the asthma review revealed the seven-year-old was not using a spacer device, reducing lung deposition to less than 10%; the nurse demonstrated correct technique and provided a written action plan."

"croup score"

A clinical scoring system, most commonly the Westley croup score, that grades the severity of laryngotracheobronchitis by assessing stridor, recession, air entry, cyanosis, and level of consciousness to guide management decisions

"A Westley croup score of 7 indicating severe croup prompted administration of nebulised adrenaline and intravenous dexamethasone, and the child was transferred to the high-dependency unit for close monitoring."

"asthma action plan"

A written, personalised document given to children with asthma and their families that specifies the child's baseline medications, how to recognise worsening symptoms at green, amber, and red zones, and which actions to take at each level

"The asthma action plan was reviewed and updated at discharge to reflect the new step-up therapy; the family confirmed understanding by correctly identifying three red-zone symptoms that required immediate emergency attendance."

"subcostal recession"

The inward drawing of the soft tissue below the costal margin during inspiration, indicating increased work of breathing due to airway obstruction or reduced lung compliance; a sign of moderate to severe respiratory distress in children

"Subcostal recession was noted alongside nasal flaring and tracheal tug in the 18-month-old, raising the respiratory distress score to moderate and necessitating supplemental oxygen and high-flow nasal cannula therapy."

"nebulisation therapy"

The delivery of aerosolised medication — most commonly bronchodilators or inhaled corticosteroids — directly to the airways via a face mask or mouthpiece attached to a device that converts liquid medication into fine inhalable particles

"Nebulisation therapy with salbutamol 2.5 mg was repeated every twenty minutes for three doses during the acute asthma exacerbation; continuous SpO₂ monitoring was maintained throughout each treatment."

"high-flow nasal cannula therapy"

The delivery of heated, humidified oxygen-air mixture at flow rates above 2 L/min in infants — typically 1 to 2 L/kg/min — to reduce the work of breathing, improve oxygenation, and avoid intubation in bronchiolitis and other lower airway diseases; abbreviated HFNC

"High-flow nasal cannula therapy at 8 L/min with FiO₂ 0.4 significantly reduced the infant's respiratory rate from 72 to 52 breaths per minute within two hours and improved feeding tolerance."

"oxygen saturation target"

The prescribed acceptable range of peripheral oxygen saturation maintained by titrating supplemental oxygen, which differs between conditions — typically 94–98% for most paediatric respiratory illnesses but 88–92% for certain preterm neonates to prevent oxygen toxicity

"The oxygen saturation target of 94–98% was communicated at handover; the incoming nurse adjusted the flow rate from 2 to 1.5 L/min when the child's SpO₂ consistently read 99–100% during sleep."

"safeguarding concern"

A professional judgement that a child may be at risk of significant harm due to abuse, neglect, exploitation, or domestic violence, which legally obligates the healthcare provider to refer to children's social care services and document the concern

"A safeguarding concern was raised when the two-year-old presented with multiple bruises in unusual sites inconsistent with the developmental stage and the history given; a referral to the named nurse for safeguarding was made before the family left the department."

"Gillick competence"

The legal principle established in English law that a child under sixteen years of age can consent to their own medical treatment without parental involvement if they have sufficient understanding and intelligence to fully comprehend what is proposed

"The fourteen-year-old requesting confidential contraceptive advice was assessed for Gillick competence; she demonstrated understanding of the risks, alternatives, and implications, and the consultation was conducted without informing her parents."

"family-centred care"

An approach to paediatric healthcare that recognises the family as the constant in a child's life and actively involves parents and carers as partners in planning, delivering, and evaluating care, rather than treating them as visitors

"Family-centred care principles guided the ward routine: parents were welcomed 24 hours a day, included in ward rounds, taught to administer enteral feeds, and invited to complete sections of the nursing documentation."

"parental consent"

The legally valid agreement given by a person with parental responsibility for a child under sixteen to a proposed investigation or treatment, based on sufficient information about the purpose, risks, benefits, and alternatives

"Parental consent for the lumbar puncture was obtained from the child's mother, who held sole parental responsibility; written consent was documented in the medical record alongside a clear explanation of the procedure."

"looked-after child"

A child or young person in the care of a local authority, either living with foster carers or in a residential setting, who has legal protections requiring healthcare providers to conduct statutory health assessments and coordinate with social care teams; abbreviated LAC

"The ward sister identified the patient as a looked-after child and contacted the virtual school head and the allocated social worker to ensure the initial health assessment was completed before discharge."

"non-accidental injury"

Physical harm inflicted on a child by an act of commission or omission that is inconsistent with the stated history, the child's developmental stage, or the normal mechanisms of injury; formerly termed non-accidental trauma; abbreviated NAI

"The skeletal survey identified bilateral posterior rib fractures of different ages alongside a subdural haematoma, findings highly concerning for non-accidental injury; a multi-agency child protection investigation was initiated."

"therapeutic play"

The structured use of play activities by nurses and play specialists to prepare children for procedures, reduce procedure-related anxiety, facilitate expression of feelings about illness and hospitalisation, and promote normal development during admission

"Therapeutic play using a syringe and doll enabled the four-year-old to act out blood tests before the real procedure; the child was noticeably less distressed and cooperative during the actual venepuncture twenty minutes later."

"transition to adult services"

The planned, coordinated process of transferring a young person with a long-term condition from paediatric to adult healthcare services, typically occurring between 14 and 18 years of age, addressing self-management skills and changes in consent and confidentiality

"Transition to adult services was planned for the sixteen-year-old with cystic fibrosis: the paediatric team held a joint clinic with the adult centre, and the young person was supported to take over medication management independently."

"paediatric dose calculation"

The mathematical process of determining the correct drug dose for a child based on body weight in kilograms, body surface area, or age, using reference sources such as the British National Formulary for Children or Paediatric Formulary to confirm dose ranges

"Paediatric dose calculation for intravenous gentamicin required the nurse to confirm the weight of 7.4 kg, calculate 7 mg/kg = 51.8 mg, round to 52 mg, and verify this fell within the BNFc maximum dose range."

"oral liquid formulation"

A liquid medicine — solution, suspension, or syrup — manufactured or compounded for administration to children who cannot swallow tablets or capsules, requiring accurate measurement with an oral syringe rather than a household spoon to ensure dose accuracy

"The oral liquid formulation of phenobarbital was supplied at 15 mg/5 mL; the nurse used a 1 mL oral syringe to measure the prescribed dose of 18 mg (6 mL) accurately before administration via the nasogastric tube."

"intramuscular injection site in children"

The anatomical location selected for intramuscular injection in paediatric patients: the anterolateral thigh is preferred in infants and toddlers, transitioning to the deltoid in older children, avoiding the gluteal region due to the risk of sciatic nerve injury

"The intramuscular injection site in the four-month-old was the anterolateral thigh; the nurse used a 25-gauge 16 mm needle at a 90-degree angle and applied firm pressure after withdrawal to minimise bruising."

"ten-fold dose error"

A medication error in which a child receives ten times the intended dose — most commonly due to a decimal point placement mistake in mg/kg calculations or syringe preparation — representing the commonest cause of serious paediatric drug harm

"The ten-fold dose error in the preparation of oral morphine was intercepted by the second-check pharmacist, who identified that 15 mg had been drawn up instead of 1.5 mg; a critical incident report was filed and the prescribing process was reviewed."

"unlicensed and off-label medication"

A drug used in children either without a product licence (unlicensed) or outside the terms of its licence regarding age, dose, or indication (off-label), requiring specific parental consent and prescriber justification, and accounting for up to 90% of drugs used in neonatal units

"The use of unlicensed and off-label medication — caffeine citrate for apnoea of prematurity — was explained to the parents, who gave verbal consent documented in the notes, as no licensed paediatric preparation was available."

"intraosseous access"

The insertion of a rigid needle directly into the medullary cavity of a long bone — typically the proximal tibia — to deliver fluids and medications during paediatric resuscitation when intravenous access cannot be rapidly established

"After two failed peripheral cannulation attempts during cardiac arrest, intraosseous access was established in the proximal tibia using a manual needle; adrenaline was administered within 90 seconds of recognition of arrest."

"topical anaesthetic cream"

A eutectic mixture of lidocaine and prilocaine applied under an occlusive dressing to intact skin for 45 to 60 minutes before a procedure to produce dermal anaesthesia, reducing pain during cannulation or venepuncture in children

"Topical anaesthetic cream was applied to two sites on the dorsum of both hands one hour before the planned intravenous cannulation, ensuring adequate dermal anaesthesia and significantly reducing the child's procedural distress."

"oral rehydration therapy"

The replacement of fluid and electrolyte losses caused by gastroenteritis using small, frequent volumes of a balanced glucose-electrolyte solution — such as Dioralyte — administered orally or via nasogastric tube rather than intravenous fluids; abbreviated ORT

"Oral rehydration therapy was commenced at 5 mL/kg every hour for the mildly dehydrated toddler; the nurse monitored urine output, wet nappies, and clinical signs of dehydration every two hours throughout the day."

"continuous glucose monitoring"

A wearable sensor system that measures interstitial glucose levels every few minutes and transmits readings to a receiver or smartphone, used in children with type 1 diabetes to reduce hypoglycaemia risk and improve glycaemic control without frequent finger-prick testing; abbreviated CGM

"Continuous glucose monitoring alerted the ward nurse at 02:00 to a rapid downward trend in glucose reaching 3.1 mmol/L; fast-acting glucose was administered and the basal insulin infusion was reduced per the agreed protocol."

"seizure observation and documentation"

The systematic recording of the onset time, duration, body parts involved, movement type, post-ictal state, and any precipitating factors during or after a seizure to assist diagnosis, guide anti-epileptic therapy, and fulfil the medicolegal record

"Seizure observation and documentation confirmed a generalised tonic-clonic episode lasting 3 minutes and 40 seconds with post-ictal drowsiness for 25 minutes; the diary entry was uploaded to the epilepsy nurse specialist portal before the morning ward round."

"palliative care in paediatrics"

An approach to improving the quality of life of children with life-limiting or life-threatening conditions and their families through prevention and relief of suffering, addressing physical, emotional, psychological, and spiritual needs from diagnosis onwards

"Palliative care in paediatrics was introduced alongside curative treatment when the eight-year-old's medulloblastoma recurred; the team supported the family in exploring wishes for end-of-life care, including preferred place of death."

"advance care plan"

A document agreed between the healthcare team, the child (where developmentally appropriate), and the family that records the child's wishes, values, and decisions about future treatment in the event of clinical deterioration, including resuscitation preferences and preferred place of care

"The advance care plan for the teenager with Duchenne muscular dystrophy was reviewed annually; this year it was updated to reflect her expressed wish for home-based ventilation and non-escalation to intensive care."

"central line-associated bloodstream infection prevention"

The bundle of evidence-based nursing practices — including hand hygiene, maximal sterile barrier precautions during insertion, chlorhexidine skin antisepsis, and daily review of line necessity — applied to reduce infections in children receiving long-term central venous access; abbreviated CLABSI prevention

"CLABSI prevention compliance was audited weekly on the oncology ward; the team achieved a sustained zero infection rate for eight months by standardising the dressing change procedure and documenting line access events."

"port-a-cath access"

The aseptic procedure of accessing a totally implanted venous access device — a subcutaneous reservoir and catheter — by inserting a non-coring Huber needle through the skin into the reservoir septum to deliver chemotherapy, blood products, or parenteral nutrition

"Port-a-cath access was performed under strict aseptic conditions using a 22-gauge Huber needle; patency was confirmed by blood return before the chemotherapy infusion was commenced to prevent extravasation injury."

"congenital heart disease monitoring"

The ongoing assessment of a child with a structural cardiac abnormality, including oxygen saturation by pulse oximetry, blood pressure in all four limbs, signs of heart failure such as hepatomegaly and poor weight gain, and recognition of cyanotic spells

"Congenital heart disease monitoring for the infant with tetralogy of Fallot included pre- and post-ductal oxygen saturation measurements, four-limb blood pressures, and daily weight checks to detect fluid retention signalling cardiac decompensation."

"chemotherapy extravasation"

The inadvertent leakage of a cytotoxic drug from a vein or catheter into surrounding tissue, which can cause severe local necrosis, pain, and functional impairment depending on the vesicant properties of the agent involved

"Chemotherapy extravasation of vincristine was suspected when the child reported burning at the infusion site and swelling was visible; the infusion was stopped immediately, the line aspirated, and the oncology pharmacist contacted for antidote guidance."