CPEN flashcards

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

Pediatric hypotension formula

For children aged 1 to 10 years, hypotension is systolic blood pressure below 70 plus twice the age in years; term neonates use below 60 and infants below 70 mm Hg.

First-dose adenosine for SVT

Adenosine 0.1 mg/kg rapid IV push, maximum 6 mg, is first-line for stable supraventricular tachycardia after vagal maneuvers; a second dose is 0.2 mg/kg, maximum 12 mg.

Pediatric defibrillation energy

Use 2 J/kg for the first shock, 4 J/kg for the second, and at least 4 J/kg for later shocks, not exceeding 10 J/kg or the adult dose.

Ductal-dependent congenital heart lesion

A newborn with cyanosis or shock from a ductal-dependent lesion may improve with prostaglandin E1 infusion; monitor for apnea and hypotension while preparing definitive management.

Pediatric stridor versus wheeze

Inspiratory stridor suggests upper airway obstruction, while expiratory wheezing suggests lower airway disease; grunting and retractions indicate increased work of breathing.

Croup dexamethasone dose

Give dexamethasone 0.6 mg/kg by mouth, intramuscularly, or intravenously, maximum 10 mg, for croup; nebulized epinephrine is added for moderate to severe stridor at rest.

Infant foreign body airway

For a choking infant under 1 year, give five back blows then five chest thrusts; do not perform abdominal thrusts. Start CPR if the infant becomes unresponsive.

Severe asthma magnesium dose

For severe pediatric asthma not responding to bronchodilators, magnesium sulfate 25 to 50 mg/kg IV, maximum 2 g, may be given over 20 minutes with monitoring.

Pediatric Glasgow Coma Scale

The pediatric Glasgow Coma Scale scores eye opening 1 to 4, verbal response 1 to 5 using age-appropriate words, and motor response 1 to 6; total ranges 3 to 15.

Status epilepticus first-line drug

Lorazepam 0.1 mg/kg IV, maximum 4 mg, is first-line for pediatric status epilepticus; alternatives include diazepam or intramuscular midazolam if IV access is delayed.

Simple febrile seizure criteria

A simple febrile seizure occurs in a child 6 months to 5 years, is generalized, lasts under 15 minutes, and happens only once in 24 hours without CNS infection.

Bilious vomiting in a newborn

Bilious vomiting in a neonate is a surgical emergency suggesting malrotation with volvulus until proven otherwise; obtain immediate surgical consultation and do not delay imaging.

Intussusception classic features

Intussusception typically affects children 6 to 36 months with colicky abdominal pain, a sausage-shaped mass, and currant-jelly stools; air or contrast enema is diagnostic and therapeutic.

Pyloric stenosis electrolyte pattern

Pyloric stenosis causes projectile nonbilious vomiting at 3 to 6 weeks, an olive-shaped mass, and hypochloremic, hypokalemic metabolic alkalosis from repeated vomiting.

Testicular torsion timing

Testicular torsion causes acute scrotal pain, a high-riding testicle, and absent cremasteric reflex; surgical detorsion is urgent, ideally within 6 hours to preserve the testicle.

Infant UTI urine specimen

In febrile infants, obtain a catheterized or suprapubic urine specimen for culture; bag specimens have high contamination rates and are not reliable for diagnosing urinary tract infection.

Nephrotic syndrome features

Nephrotic syndrome shows edema, heavy proteinuria, hypoalbuminemia, and hyperlipidemia; most children respond to corticosteroids, and infection is a major complication.

Compartment syndrome early sign

The earliest sign of compartment syndrome is pain out of proportion to injury, especially with passive stretch; pallor, paresthesia, paralysis, and pulselessness are later findings.

Supracondylar fracture assessment

With a pediatric supracondylar humerus fracture, assess radial pulse, capillary refill, and median nerve function; keep the arm supported and seek urgent orthopedic evaluation.

Salter-Harris fracture types

Salter-Harris I involves physis only, II physis and metaphysis, III physis and epiphysis, IV all three, and V a physeal crush injury.

Pediatric burn fluid formula

For major pediatric burns, Parkland formula uses 4 mL/kg per percent total body surface area of lactated Ringer in 24 hours, half in the first 8 hours, plus maintenance fluids.

Necrotizing fasciitis red flags

Necrotizing fasciitis causes pain out of proportion, rapidly spreading erythema, crepitus, bullae, and systemic toxicity; it is a surgical emergency requiring debridement and antibiotics.

Stevens-Johnson syndrome care

Stevens-Johnson syndrome causes mucosal erosions and epidermal detachment after medication exposure; stop the trigger, support fluids and wound care, and monitor for sepsis.

Neutropenic fever definition

Fever in a neutropenic child is a single temperature of 38.3 C or higher, or 38.0 C sustained over one hour, with absolute neutrophil count below 500 cells/microL.

Tumor lysis syndrome labs

Tumor lysis syndrome causes hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia; aggressive hydration and allopurinol or rasburicase help prevent renal failure.

Transfusion reaction first action

If a transfusion reaction is suspected, stop the transfusion immediately, keep the IV line open with normal saline, and notify the blood bank and provider.

Pediatric DKA initial fluid

In pediatric diabetic ketoacidosis, give a 10 to 20 mL/kg isotonic saline bolus for shock, then start insulin at 0.05 to 0.1 units/kg/hour with careful monitoring for cerebral edema.

Hypoglycemia treatment dose

Treat symptomatic pediatric hypoglycemia with dextrose 0.5 to 1 g/kg IV; D10 at 5 mL/kg provides 0.5 g/kg, and recheck glucose after treatment.

Congenital adrenal hyperplasia crisis

Salt-wasting congenital adrenal hyperplasia can cause hypotension, hyponatremia, hyperkalemia, and hypoglycemia; treat with hydrocortisone and isotonic fluid resuscitation.

Adolescent suicide risk screening

Ask adolescents directly about suicidal thoughts, plan, intent, and access to means; a high-risk patient needs continuous observation and emergent mental health evaluation.

Mandatory child abuse reporting

Nurses are mandated reporters; report suspected child abuse to the designated agency, document objective findings, and do not confront or investigate the family independently.

Physical restraint in behavioral emergency

Use physical restraints only for imminent danger after less restrictive measures fail, obtain an order, monitor airway, circulation, and vital signs, and reassess frequently.