PNPSS flashcards

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

Bright Futures visit schedule

AAP preventive care schedule: 14 visits before age 12 months, then annual well-child visits from age 3 through 21 years, with developmental screening at set ages.

Developmental screening ages

AAP recommends standardized developmental screening at 9, 18, and 30 months, and autism-specific screening with the M-CHAT-R/F at 18 and 24 months.

Lead screening schedule

Universal blood lead screening at 12 and 24 months for Medicaid-enrolled children; targeted screening for others based on risk factors and state requirements.

Screen time guidance

AAP recommends avoiding screen time for children under 18-24 months and limiting to 1 hour or less per day of high-quality programming for ages 2-5.

Growth chart selection

Use WHO growth standards for children under 2 years and CDC 2000 growth charts for ages 2-20 years when plotting length, weight, and BMI.

Developmental red flags

No babbling by 9 months, no gestures by 12 months, no single words by 16 months, and no two-word phrases by 24 months warrant further evaluation.

Failure to thrive definition

Growth failure marked by weight or height crossing two or more major percentile lines, or weight-for-length below the 5th percentile, requiring evaluation.

Head circumference alarm

Rapid head growth crossing percentiles upward or a bulging fontanel may indicate hydrocephalus or increased intracranial pressure and needs urgent evaluation.

Infant fever under 3 months

Fever of 38 degrees C or higher in an infant under 3 months requires a full sepsis workup with blood, urine, and CSF cultures and empiric antibiotics.

Acute otitis media treatment

First-line therapy is high-dose amoxicillin 80-90 mg/kg/day; observation is an option for children over 2 years with mild symptoms.

Bronchiolitis management

Supportive care with hydration and oxygen is the mainstay; routine bronchodilators, corticosteroids, and antibiotics are not recommended for bronchiolitis.

Croup treatment

A single dose of dexamethasone 0.15-0.6 mg/kg (max 10 mg) is first-line; nebulized epinephrine is added for moderate to severe stridor.

Kawasaki disease criteria

Fever for 5 or more days plus 4 of 5 criteria: rash, conjunctivitis, oral changes, extremity changes, and cervical lymphadenopathy; treat with IVIG and aspirin.

Asthma control assessment

Use the ACT or C-ACT to assess control; persistent asthma requires daily inhaled corticosteroids, and SABA is used for quick relief.

ADHD diagnostic criteria

DSM-5 requires 6 or more inattention and/or hyperactivity-impulsivity symptoms for at least 6 months, with impairment in 2 or more settings.

Cystic fibrosis diagnosis

A sweat chloride of 60 mmol/L or higher on two tests is diagnostic; newborn screening with elevated IRT requires confirmatory sweat testing.

Sickle cell prophylaxis

Penicillin prophylaxis from 2 months to 5 years, pneumococcal vaccination, and annual transcranial Doppler screening reduce infection and stroke risk.

Acetaminophen dosing

Acetaminophen 10-15 mg/kg every 4-6 hours as needed, with a maximum of 75 mg/kg/day, is used for fever and pain in children.

Ibuprofen dosing

Ibuprofen 10 mg/kg every 6-8 hours as needed is used for fever and pain in children over 6 months; avoid in dehydration or renal impairment.

Reye syndrome risk

Aspirin should be avoided in children with viral illness because of the risk of Reye syndrome; it is used in Kawasaki disease and selected conditions.

Antibiotic stewardship

Avoid antibiotics for viral upper respiratory infections, bronchiolitis, and most mild acute otitis media in children over 2 years to prevent resistance.

Teach-back method

Ask the family to explain the care plan in their own words to confirm understanding and identify gaps in health literacy.

Shared decision-making

Present options, discuss risks and benefits, elicit family values, and reach a mutually agreed plan with the family.

Interpreter use

Use qualified medical interpreters, not family members, for discussions involving consent, complex decisions, or sensitive information.

Adolescent confidentiality

Provide time alone with the adolescent at preventive visits and explain confidentiality limits, including safety concerns that require disclosure.

Assent versus consent

Parents or guardians provide informed consent for minors; assent is obtained from children old enough to understand, typically age 7 and older.

Mandatory reporting

Report suspected child abuse or neglect to child protective services; reporting is required regardless of proof or certainty.

Ethical principles

Autonomy, beneficence, nonmaleficence, and justice guide pediatric decisions, with the child's best interest as the standard.

PICO framework

Population, Intervention, Comparison, Outcome - a structure used to formulate a searchable clinical question for evidence-based practice.

PDSA cycle

Plan-Do-Study-Act is a quality improvement method that tests changes on a small scale before spreading them more widely.

Evidence hierarchy

Systematic reviews and meta-analyses of RCTs rank highest, followed by individual RCTs, cohort studies, case reports, and expert opinion.

Medical home model

A medical home with care coordination improves outcomes and reduces emergency visits for children with special health care needs.