CCRN Pediatric flashcards

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

Pediatric hypotension threshold

In children, hypotension is a late sign of shock; a systolic pressure below the 5th percentile for age, or roughly <70 mmHg plus twice age in years, warrants immediate resuscitation.

PALS epinephrine dose arrest

For pediatric cardiac arrest, IV/IO epinephrine is 0.01 mg/kg of 1:10,000 concentration, repeated every 3 to 5 minutes; maximum single dose is 1 mg.

Pediatric defibrillation energy

Initial pediatric defibrillation is 2 J/kg; second shock 4 J/kg; subsequent shocks at least 4 J/kg, not exceeding 10 J/kg or the adult maximum dose.

Maintenance fluid 4-2-1 rule

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 kg.

Pediatric sepsis fluid bolus

Initial resuscitation for pediatric septic shock uses 20 mL/kg isotonic crystalloid boluses, reassessing after each; give antibiotics within 1 hour and start vasoactive support for fluid-refractory shock.

Cushing triad in children

Hypertension with widened pulse pressure, bradycardia, and irregular respirations indicates increased intracranial pressure and brain herniation risk; it is a late, ominous finding in children.

Tet spell management

For a hypercyanotic tet spell, place the infant knee-to-chest, give oxygen, morphine, IV fluids, and phenylephrine; avoid crying and proceed to emergency surgery if refractory.

Ductal-dependent lesion treatment

Prostaglandin E1 infusion maintains ductal patency in ductal-dependent congenital heart lesions; monitor for apnea, hypotension, fever, and jitteriness, and have airway support available.

Pediatric GCS eye score

Eye opening: 4 spontaneous, 3 to sound/speech, 2 to pain, 1 none; verbal and motor scores are age-adjusted in young children.

FLACC pain scale

FLACC assesses pediatric pain using five behaviors: face, legs, activity, cry, and consolability; each scored 0 to 2 for a total of 0 to 10, useful for preverbal or nonverbal children.

DKA cerebral edema signs

In pediatric diabetic ketoacidosis, headache, altered mental status, bradycardia, hypertension, and decreasing oxygen saturation suggest cerebral edema; treat urgently with hypertonic saline or mannitol and slow fluid correction.

Croup versus epiglottitis

Croup causes barking cough and inspiratory stridor, often viral; epiglottitis causes drooling, tripod positioning, high fever, and muffled voice, and the airway must not be inspected without readiness for emergency intubation.

Febrile seizure first-line

For a febrile seizure lasting longer than 5 minutes, give a benzodiazepine such as lorazepam or midazolam; ongoing seizures require escalation and evaluation for meningitis when indicated.

Acetaminophen antidote

N-acetylcysteine is the antidote for acetaminophen toxicity; use the Rumack-Matthew nomogram for acute ingestions and start treatment promptly when hepatotoxicity risk is present.

Neonatal jaundice treatment

Phototherapy is indicated for neonatal hyperbilirubinemia based on age in hours, gestational age, and risk factors; exchange transfusion is reserved for severe or refractory cases with kernicterus risk.

Pediatric respiratory distress signs

Nasal flaring, grunting, retractions, accessory muscle use, and head bobbing indicate increased work of breathing in infants; silent chest or exhaustion signals impending respiratory failure.

Infant car seat safety

Infants should ride rear-facing in a federally approved car seat until age 2 or until they reach the seat's height and weight limits; the harness should be snug with the chest clip at armpit level.

Pediatric burn fluid formula

The Parkland formula estimates 4 mL/kg per percent total body surface area burned of lactated Ringer solution in 24 hours; give half in the first 8 hours from injury and the remainder over 16 hours.

Hypoglycemia in neonates

Neonatal hypoglycemia is commonly defined as blood glucose below 40 mg/dL in the first 24 hours; treat with feeding or IV dextrose and monitor because seizures and neuroglycopenia can occur.

Pediatric code team activation

Activate the pediatric rapid response or code team for respiratory distress, cyanosis, new lethargy, seizure, or hypotension; early escalation improves outcomes and is expected rather than discouraged.

Appropriate pediatric IV fluid

Isotonic crystalloid such as 0.9% sodium chloride or lactated Ringer is preferred for pediatric resuscitation and maintenance in most hospitalized children; hypotonic fluids risk hyponatremia.

Pediatric asthma severe exacerbation

Severe pediatric asthma is treated with repeated inhaled albuterol, ipratropium, systemic corticosteroids, and oxygen; add magnesium sulfate or epinephrine for refractory symptoms and prepare for ventilatory support.

Family-centered care principle

Family-centered care recognizes the family as a constant in the child's life and collaborates with them in assessment, decision-making, and care planning while respecting cultural values and preferences.

Informed consent in pediatrics

Parents or legal guardians provide informed consent for minors; adolescents may give assent, and emancipated or mature minors may consent independently depending on state law and institutional policy.

Pediatric assent

Assent is the child's agreement to participate in care or research after developmentally appropriate explanation; it complements, but does not replace, parental informed consent.

Mandated reporting duty

Nurses must report suspected child abuse or neglect to designated child protective authorities, even without proof; reporting in good faith is protected and failure to report can be legally actionable.

Nursing delegation rule

Delegation transfers task performance, not accountability; the registered nurse retains responsibility for assessment, teaching, evaluation, and deciding whether the delegate is competent for the task.

Ethical principle of veracity

Veracity is the duty to tell the truth; in pediatrics it supports developmentally appropriate honesty with the child and family, including disclosure of errors and uncertain outcomes.

Moral distress definition

Moral distress occurs when a nurse knows the right action but feels constrained from taking it by institutional, legal, or hierarchical barriers; it can contribute to burnout and should be addressed through ethics support.

Just culture in nursing

Just culture distinguishes human error from at-risk behavior and reckless conduct; it encourages error reporting and system improvement while holding individuals accountable for unsafe choices.

Palliative care in pediatrics

Pediatric palliative care begins at diagnosis of a serious illness and continues alongside curative treatment; it addresses pain, symptom control, communication, and family support across settings.

Organ donation notification

When a pediatric patient meets death criteria or withdrawal is planned, notify the organ procurement organization; donation discussions should be separated from clinical care decisions and handled by trained requesters.