CPNP-AC key terms

A rapid, hands-off first impression of an infant or child built from three components: appearance, work of breathing, and circulation to the skin. It sets the urgency of assessment before vital signs are measured.

Hypertension with widened pulse pressure, bradycardia, and irregular respirations occurring together. It signals rising intracranial pressure and impending herniation and is considered a late, ominous finding.

The number of seconds needed for color to return to a blanched fingertip or the sternum after pressure is applied. It is a bedside marker of peripheral perfusion used in shock assessment.

The difference between systolic and diastolic blood pressure. Widening or narrowing helps distinguish types of shock, such as distributive versus hypovolemic or cardiogenic states.

Heart rate divided by systolic blood pressure. An elevated value in a child suggests failing compensation and has been studied as a screen for occult shock requiring resuscitation.

The calculated difference between measured cations and anions in serum, used to sort metabolic acidosis into elevated-gap and normal-gap categories and to narrow the differential diagnosis.

A scored assessment of eye opening, verbal response, and motor response, with anchors adapted for preverbal children. Total scores run from 3 to 15 and are trended over time.

Bedside sonography performed and interpreted by the treating clinician to answer focused questions, such as whether a pericardial effusion or lung sliding is present, shortening time to a decision.

A bedside score combining behavioral, cardiovascular, and respiratory findings to detect deterioration on inpatient units and trigger escalation according to a defined response protocol.

A strategy using low tidal volumes near 6 mL/kg of predicted body weight, limited plateau pressures, and adequate positive end-expiratory pressure to reduce ventilator-induced injury in acute respiratory distress syndrome.

The airway pressure held at end expiration that keeps alveoli open and improves oxygenation. Higher levels may recruit lung but can impair venous return and cardiac output.

A measured volume of isotonic crystalloid, commonly 10 to 20 mL/kg in children, infused rapidly to restore intravascular volume. Reassessment after each bolus determines whether more fluid is needed.

A set of time-bound actions, including cultures before antibiotics, prompt broad-spectrum antibiotics, lactate measurement, and fluid resuscitation, that improves survival when completed quickly in septic shock.

A continuously infused medication such as epinephrine, norepinephrine, or milrinone that changes vascular tone or myocardial contractility. These drugs demand secure access, pump accuracy, and close hemodynamic monitoring.

The coordinated administration of a sedative and a neuromuscular blocking agent to create ideal conditions for emergency tracheal intubation while limiting aspiration risk and procedure time.

Continuous seizure activity, or repeated seizures without regaining awareness, lasting five minutes or longer. Treatment proceeds in stages from benzodiazepines to second-line antiseizure drugs and then continuous infusions.

A life-threatening complication of pediatric diabetic ketoacidosis marked by headache, declining consciousness, and bradycardia. Treatment includes hyperosmolar therapy and slowing the rate of fluid and insulin administration.

Circulation of blood through an oxygenator outside the body to support failing heart or lungs when conventional therapies no longer suffice, requiring anticoagulation, specialized circuitry, and an experienced team.

Controlled cooling of the body, usually to 33 to 36 degrees Celsius, after cardiac arrest or hypoxic-ischemic injury to limit secondary neurologic damage, requiring precise temperature control and monitoring for arrhythmia and coagulopathy.

A definition requiring acute onset within one week, bilateral opacities on imaging, edema not fully explained by cardiac failure, and hypoxemia graded by the ratio of arterial oxygen to inspired oxygen.

An acute, fluctuating disturbance of attention and awareness common in critically ill children. It is screened with tools such as the Cornell Assessment of Pediatric Delirium and managed with sleep, mobility, and family presence.

New or worsening physical, cognitive, or psychological impairment that persists after critical illness, affecting both children and their families; screening and rehabilitation begin during the intensive care stay.

Bedside rounds that treat the patient and family as team members, invite questions, and explain the plan in plain language, improving trust, safety, and shared understanding of care.

A technique in which the clinician asks the family to explain instructions back in their own words, revealing gaps in understanding that can be corrected before discharge.

A collaborative conversation in which clinicians explain options and evidence while families contribute values, goals, and preferences, producing a plan both parties endorse for preference-sensitive decisions.

An approach that assumes many patients and families have experienced adversity and avoids retraumatization by prioritizing safety, choice, trustworthiness, collaboration, and empowerment in every encounter.

Conditions of birth, growth, living, working, and aging that shape health, including food and housing security, transportation, and neighborhood safety; screening helps connect families to resources.

The degree to which a person can find, understand, and use health information to make decisions. Limited literacy calls for plain language, pictures, and confirmation that instructions were understood.

A team-based primary care model offering continuous, coordinated, accessible, and family-centered care. Acute providers communicate with it to arrange follow-up and prevent fragmented care after discharge.

A rapid-cycle improvement method: plan a change, test it on a small scale, study the results, then act by adopting, adapting, or abandoning the change before wider spread.

A structured retrospective review of a serious event that maps contributing system factors rather than individual blame and produces recommendations intended to prevent recurrence.

An organizational climate that separates human error, at-risk behavior, and reckless conduct, encouraging staff to report mistakes while holding people accountable for knowingly unsafe choices.

An unexpected occurrence involving death, serious physical or psychological injury, or the risk of either, which triggers immediate investigation, system changes, and disclosure to the patient and family.

The range of services a clinician is legally and professionally authorized to provide, defined by state law, licensure, certification, and institutional policy or privileging.

A written document describing how a nurse practitioner and physician share patient care responsibilities, including consultation, referral, and prescriptive authority, as required by state regulation.

The experience of knowing the right action but being blocked from taking it by institutional or other constraints; repeated episodes contribute to burnout, disengagement, and departure from critical care practice.

A prospective team method that breaks a process into steps, identifies how each step could fail, and prioritizes fixes for failures that are most severe and most likely.