Children's nursing assessment of a child with a high fever
NMC OSCE practice station

The task

You are a children's nurse in a paediatric assessment unit. Poppy Clarke, aged 3, has had a high temperature for two days. Her mother is with her. A paediatric doctor can be reached by phone. Introduce yourself to Poppy and her mother, and carry out a systematic assessment of the child using an A to E approach. Record her observations and your assessment on the chart provided. Decide who you need to tell and how urgently, and explain the plan to her mother. Say aloud what you are checking and why.

What this station tests

• Assess the child in the parent's arms and speak to the child as well as the adult.
• Use a traffic-light approach: heart rate, breathing, perfusion, hydration and behaviour all count.
• Always look for a non-blanching rash, neck stiffness and drowsiness in a feverish child.
• Fever alone does not tell you how ill a child is; do not rely on response to paracetamol.
• Take parents' worries seriously and explain the plan clearly.

Sources for the clinical content

• NICE NG143: Fever in under 5s: assessment and initial management
• NICE NG254: Suspected sepsis in under 16s
• NICE NG240: Meningitis (bacterial) and meningococcal disease
• NMC: The Code

An original practice scenario with invented patients. Not an exam question.

Practise next

• Breathless older patient with a chest infection
• Worsening abdominal pain after bowel surgery
• Confused patient after a fall with a head injury
• Midwifery postnatal home visit with a feeding problem
• Midwifery assessment of reduced baby movements