CCRN-K Pediatric flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Pediatric hypotension definition

Hypotension is a late sign of shock in children. Use age-specific thresholds: systolic below 70 plus twice age in mmHg for ages 1-10 years; treat compensated shock signs before pressure falls.

Holliday-Segar maintenance fluids

Hourly maintenance fluid equals 4 mL/kg for the first 10 kg, plus 2 mL/kg for the next 10 kg, plus 1 mL/kg for each kilogram above 20.

Pediatric early warning score

A validated track-and-trigger tool combining respiratory rate, oxygen saturation, work of breathing, heart rate, blood pressure, and behavior. Escalate when a single parameter scores 3 or total reaches 4.

Signs of respiratory failure

Respiratory failure differs from distress: bradypnea, apnea, cyanosis, silent chest, and declining consciousness appear. Immediate bag-mask ventilation and airway support are required.

FLACC pain scale

Behavioral pain tool for children 2 months to 7 years scoring Face, Legs, Activity, Cry, and Consolability from 0 to 2 each, for a total of 0 to 10.

Pediatric sepsis bundle timing

Obtain blood cultures, give broad-spectrum antibiotics within 60 minutes of sepsis recognition, and administer 10-20 mL/kg isotonic fluid boluses with reassessment after each bolus.

Dehydration severity grading

Mild dehydration is under 5% weight loss, moderate is 5-10%, and severe exceeds 10% with lethargy, sunken eyes, and delayed capillary refill. Oral rehydration is preferred when tolerated.

Compensated shock indicators

Tachycardia, delayed capillary refill over 2 seconds, cool mottled extremities, narrow pulse pressure, and irritability indicate compensated shock before blood pressure drops.

Informed consent elements

Consent requires disclosure of diagnosis, proposed treatment, risks, benefits, alternatives, and consequences of refusal, given voluntarily by the legally authorized representative and documented.

Nurse role in consent

The provider obtains informed consent. The nurse witnesses the signature, verifies understanding, clarifies information, and advocates if the family appears uninformed or coerced.

Mandated reporting threshold

Nurses must report suspected child abuse or neglect to child protective services based on reasonable suspicion, not proof. Reporting is a legal duty and cannot be delegated away.

Pediatric assent

Assent is a child's developmentally appropriate agreement to care, typically sought from about age 7 years and older. Dissent should be honored when treatment can safely wait.

Emancipated minor consent

Emancipated minors, married minors, minor parents, and some minors in military service may consent to their own care. Verify state statute because criteria differ by jurisdiction.

Confidentiality exceptions

Confidentiality may be breached for suspected abuse, imminent danger to self or others, reportable communicable diseases, and court orders, disclosing only the minimum necessary information.

Best-interest standard

Surrogate decision-makers for children choose based on the child's best interests, weighing benefits and burdens, prior expressed values, and what a reasonable person would choose.

Family-centered care principles

Core elements are dignity and respect, information sharing, participation, and collaboration. Parents are part of the care team and may remain present during resuscitation with a support facilitator.

Ethics consultation trigger

Request ethics consultation when there is disagreement about goals of care, disputed futility, conflict between surrogate and team, or uncertainty about consent authority.

Teach-back method

The learner explains the information back in their own words or demonstrates the skill. The nurse confirms correct understanding and reteaches gaps, documenting the result.

Health literacy universal precautions

Assume all families may have limited health literacy. Use plain language, pictures, and written material at or below a 5th-6th grade reading level, and limit content to key actions.

Asthma action plan zones

Green zone means well controlled with no symptoms; yellow zone means increasing symptoms or peak flow at 50-79% of personal best; red zone means severe distress requiring immediate rescue medication and 911.

Inhaler with spacer teaching

A spacer improves lung deposition and reduces oropharyngeal side effects. Teach shake, attach, exhale, press and inhale slowly, hold breath 10 seconds, and rinse after corticosteroids.

Interpreter use standards

Use qualified medical interpreters for limited-English-proficiency families. Never use the child or untrained family members as interpreters; document interpreter use and language preference.

Discharge readiness criteria

Caregivers demonstrate medication administration, state warning signs requiring return, identify follow-up appointments, and have a 24-hour contact number and written instructions.

Developmental teaching strategies

Preschoolers need concrete, brief, play-based teaching; school-age children understand simple cause and effect; adolescents need privacy, self-management skills, and peer-sensitive explanations.

Transition to adult care

Begin transition planning in early adolescence. By ages 14-16 the youth should know their diagnosis, medications, allergies, and how to access care and insurance.

Advocacy escalation chain

When an order or situation threatens patient safety, the nurse states the concern, uses SBAR, and escalates through charge nurse, supervisor, and attending until resolved, documenting each step.

PDSA cycle

Plan-Do-Study-Act is a rapid improvement method using small tests of change, measuring results, and adapting or scaling before broad implementation across a unit.

Root cause analysis

A retrospective, multidisciplinary review after a sentinel event that identifies system failures and contributing factors, producing an action plan with measurable outcomes rather than individual blame.

Failure mode and effects analysis

A prospective risk assessment that maps a process, identifies where it can fail, and ranks risks by severity, occurrence, and detection to prioritize preventive redesign.

Just culture framework

Just culture responds to human error with support, at-risk behavior with coaching, and reckless behavior with disciplinary action, encouraging voluntary error reporting and system learning.

High-alert medication safeguards

Use independent double-checks, weight-only kilogram dosing, standardized concentrations, smart pump libraries, and barcode administration for insulin, opioids, heparin, chemotherapy, and concentrated electrolytes.

Nurse-sensitive quality indicators

Outcomes influenced by nursing care include falls with injury, hospital-acquired pressure injuries, central line-associated bloodstream infections, catheter-associated urinary tract infections, and patient satisfaction scores.