CPNP-AC flashcards

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

Pediatric Assessment Triangle

Rapid 30-60 second visual and auditory assessment of appearance, work of breathing, and circulation to skin, performed before hands-on examination to classify a child as respiratory, circulatory, or neurologically unstable.

Holliday-Segar maintenance fluids

Daily fluid requirement calculated as 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kilogram thereafter.

4-2-1 rule

Hourly maintenance fluid rate: 4 mL/kg/hr for the first 10 kg, 2 mL/kg/hr for the next 10 kg, and 1 mL/kg/hr for every kilogram above 20 kg.

Age-based hypotension threshold

Systolic pressure below 70 mmHg in infants 1-12 months, below 70 plus twice the age in years for children 1-10 years, and below 90 mmHg at 10 years and older.

Pediatric Glasgow Coma Scale

Score of 3-15 derived from eye (4), verbal (5), and motor (6) components; modified verbal scoring is used for preverbal or intubated children, and lower scores indicate deeper impairment.

Cushing triad

Hypertension with a widened pulse pressure, bradycardia, and irregular respirations representing a late and ominous sign of raised intracranial pressure in children.

Capillary refill time

Time for color to return after blanching a nail bed or sternum; greater than 2 seconds suggests reduced peripheral perfusion and is one component of the shock assessment.

Tachycardia in pediatric shock

Heart rate elevation is an early compensatory response to falling cardiac output; hypotension appears late because children preserve blood pressure through vasoconstriction.

Cardiac arrest epinephrine dose

0.01 mg/kg, given as 0.1 mL/kg of the 1:10,000 concentration, IV or IO, maximum 1 mg per dose, repeated every 3-5 minutes during pediatric resuscitation.

Pediatric defibrillation energy

First shock 2 J/kg, second shock 4 J/kg, and subsequent shocks at least 4 J/kg but not exceeding 10 J/kg or the adult dose.

Septic shock fluid bolus

Isotonic crystalloid 20 mL/kg over 5-20 minutes with reassessment after each bolus; fluid-refractory shock may require 40-60 mL/kg within the first hour.

Cold shock vasoactive choice

Epinephrine infusion at 0.05-0.3 mcg/kg/min when shock presents with low cardiac output, delayed capillary refill, mottling, and elevated systemic vascular resistance.

Warm shock vasoactive choice

Norepinephrine at 0.05-0.3 mcg/kg/min when shock presents with vasodilation, flash capillary refill, bounding pulses, and low systemic vascular resistance.

DKA insulin infusion

Start regular insulin 0.05-0.1 units/kg/hr after initial isotonic fluid resuscitation; add dextrose-containing fluid when glucose reaches 250-300 mg/dL and continue insulin until ketoacidosis resolves.

Status asthmaticus magnesium sulfate

Magnesium sulfate 25-50 mg/kg IV (maximum 2 g) infused over 15-30 minutes as adjunctive therapy for severe exacerbation not responding to bronchodilators and corticosteroids.

Lung-protective ventilation targets

Tidal volume 6-8 mL/kg predicted body weight, plateau pressure under 30 cmH2O, titrated positive end-expiratory pressure, and tolerance of permissive hypercapnia in pediatric acute respiratory distress syndrome.

Family-centered care principles

Four core concepts guide practice: dignity and respect, information sharing, participation in care, and collaboration with families in decision-making at every level.

FLACC pain scale

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

Wong-Baker FACES scale

Self-report pain tool using six faces rated 0-10, validated for children aged 3 years and older who can understand increasing pain intensity.

NIPS pain scale

Neonatal Infant Pain Scale scores facial expression, cry, breathing pattern, arms, legs, and state of arousal from 0-7 for preterm and term infants.

Teach-back method

The caregiver restates or demonstrates discharge instructions in their own words; incomplete or incorrect recall triggers re-teaching before the family leaves.

Atraumatic care

Interventions that reduce the physical and psychological distress of health care by minimizing separation, limiting invasive procedures, and promoting caregiver presence and child control.

Pediatric assent

Developmental agreement to participate in care or research, typically sought from children 7 years and older, alongside the legally required parental or guardian permission.

Influenza vaccination age rule

Annual influenza vaccine is recommended for all children 6 months and older; children 6 months through 8 years receiving it for the first time need two doses at least four weeks apart.

PDSA cycle

Plan-Do-Study-Act: an iterative improvement method in which a small test of change is planned, carried out, analyzed, and then adopted, adapted, or abandoned.

Root cause analysis

Retrospective, team-based method used after a sentinel event to identify system-level contributing factors and design actions that prevent recurrence.

Failure mode and effects analysis

Prospective quality tool that maps a process step by step to identify where failures could occur and to prioritize risk reduction before harm reaches a patient.

IOM six aims

Health care should be safe, effective, patient-centered, timely, efficient, and equitable; these aims frame quality measurement and improvement in acute care.

APRN Consensus Model

Regulatory model defining four APRN roles and six population foci, aligning licensure, accreditation, certification, and education across states.

Scope of practice authority

Determined by each state's nurse practice act and board of nursing rules, ranging from full to reduced or restricted practice; certification alone does not grant practice authority.

Never event

Serious, largely preventable safety incident such as wrong-site surgery or a retained foreign body that is reportable and generally not reimbursed as a hospital-acquired condition.

Mandatory reporting duty

Legal obligation to report suspected child abuse, neglect, or exploitation to designated authorities; the report is made in good faith without the clinician first confirming the suspicion.