CPN CPE CIS flashcards

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

Infant weight milestones

Birth weight doubles by 4-6 months, triples by 12 months, and quadruples by 24 months; birth weight is usually regained by 10-14 days of age.

Anterior fontanel closure

The anterior fontanel closes between 9 and 18 months of age. A sunken fontanel suggests dehydration, while a bulging fontanel suggests increased intracranial pressure.

APGAR scoring

Scored at 1 and 5 minutes on appearance, pulse, grimace, activity, and respiration, each 0-2 points. It assesses response to resuscitation and never guides ongoing resuscitation decisions.

FLACC pain scale

Behavioral pain tool for children aged 2 months to 7 years, scoring face, legs, activity, cry, and consolability from 0 to 10. Useful when the child cannot self-report.

Exclusive breastfeeding duration

Exclusive breastfeeding is recommended for about the first 6 months, with iron-fortified complementary foods started around 6 months and breastfeeding continued to 12 months or longer.

Honey contraindication

Honey is withheld from infants under 12 months because it can contain Clostridium botulinum spores and cause infant botulism, which can be fatal.

Safe sleep recommendations

Place infants supine on a firm flat surface with no loose bedding or soft objects, and room-share without bed-sharing. These measures reduce the risk of sudden infant death syndrome.

Immunizations at 12-15 months

Measles-mumps-rubella and varicella vaccines are given at 12-15 months, along with Haemophilus influenzae type b and pneumococcal conjugate boosters per the current schedule.

Atraumatic care principles

Minimize separation from family, minimize physical and emotional harm, and promote a sense of control. These principles guide preparation and support during procedures.

Teach-back method

Ask the caregiver to explain the plan in their own words rather than asking whether they understand. This reveals actual comprehension gaps and supports safe home care.

Medical interpreter use

Use a qualified medical interpreter, not a child or sibling, for families with limited English proficiency. Document interpreter use and language preference in the record.

Pediatric assent and consent

Parents or guardians give legal consent, while the child provides developmentally appropriate assent. Decisions follow the best-interest standard for the child.

Oral rehydration volume

For mild to moderate dehydration, give oral rehydration solution at 50 mL/kg over 4 hours, replacing ongoing losses and reassessing hydration status frequently.

Kawasaki disease treatment

Fever for 5 or more days with mucocutaneous findings is treated with intravenous immunoglobulin and aspirin to prevent coronary artery aneurysm formation.

DKA insulin rule

Never give a bolus of insulin to a child in diabetic ketoacidosis. Rehydrate first, then start continuous insulin, and watch closely for cerebral edema.

Bronchiolitis management

Treatment is supportive: oxygen, hydration, and suctioning. Routine bronchodilators, corticosteroids, and antibiotics are not recommended for typical bronchiolitis.

Pediatric compression ratio

Use 30:2 for a single rescuer and 15:2 for two rescuers with an infant or child. Compress at 100-120 per minute to one-third of chest depth.

Pediatric defibrillation energy

Use 2 J/kg for the first shock, 4 J/kg for the second, and 4 J/kg or more for subsequent shocks, up to the maximum energy of the device.

Pediatric fluid bolus

Give 20 mL/kg of isotonic crystalloid and reassess after each bolus. Use 10 mL/kg in neonates, cardiac patients, and diabetic ketoacidosis.

Anaphylaxis epinephrine dose

Give intramuscular epinephrine 0.01 mg/kg of the 1 mg/mL concentration, maximum 0.5 mg, into the anterolateral thigh, repeating every 5-15 minutes as needed.

Tenfold medication error

A misplaced decimal point in a pediatric dose can create a tenfold error. Always verify the ordered dose against the safe mg/kg range for the child's weight.

Rule of six

For continuous infusions, mg of drug in 100 mL equals dose in mcg/kg/min times weight in kg times 6, divided by the infusion rate in mL/h.

Aspirin in children

Aspirin is avoided in children with viral illness because of the risk of Reye syndrome, which causes acute encephalopathy and liver dysfunction.

High-alert medication double-check

Insulin, heparin, opioids, and concentrated electrolytes require an independent double-check by a second nurse before administration to prevent serious harm.

PICC tip location

The tip should sit in the lower third of the superior vena cava or at the cavoatrial junction, confirmed by imaging before the catheter is used.

Pediatric blood transfusion rate

Transfuse 10-15 mL/kg over 3-4 hours using a 170-260 micron filter. Only 0.9% sodium chloride is compatible in the same line.

Extravasation response

Stop the infusion, leave the catheter in place, aspirate residual drug, and follow the specific antidote protocol. Do not flush the line before aspirating.

Drip rate formula

Flow rate in mL/h equals drops per minute times 60 divided by the drop factor in drops per mL. Pediatric maintenance fluids should use a pump.

Two patient identifiers

Verify name plus date of birth or medical record number before any medication, blood product, or procedure. Room number is never an acceptable identifier.

SBAR handoff

A structured handoff covering situation, background, assessment, and recommendation. It improves communication during transitions of care and reduces omissions.

Root cause analysis

A retrospective, systems-focused review conducted after a sentinel event. Failure mode and effects analysis is the proactive counterpart done before a process change.

Child abuse reporting

Nurses must report suspected child abuse or neglect based on reasonable suspicion, not proof, following state law and institutional policy.