CPNP-PC cheat sheet

Bright Futures preventive visit ages: 3–5 days, 1, 2, 4, 6, 9, 12, 15, 18, 24, and 30 months, then annually from 3 through 21 years.

Developmental surveillance occurs at every visit; autism-specific screening with the M-CHAT-R/F is performed at the 18-month and 24-month visits.

Vitamin D 400 IU/day for all breastfed infants starting in the first days of life; iron 1 mg/kg/day from 4 months until iron-rich complementary foods meet requirements.

Immunization anchors: DTaP at 2, 4, 6, 15–18 months and 4–6 years; MMR and varicella at 12–15 months and 4–6 years; HPV, Tdap, and MenACWY at 11–12 years; annual influenza from 6 months.

Universal hemoglobin screening at about 12 months; blood pressure at every visit from age 3; instrument-based vision screening at 12 months and again at 3–5 years.

BMI percentile cutoffs for ages 2–20: 85th–94th percentile = overweight, ≥95th = obesity, ≥99th = severe obesity.

Fluoride varnish every 3–6 months from eruption of the first tooth through age 5; systemic fluoride supplement only when the water supply is below 0.6 ppm.

Safe sleep: supine for every sleep on a firm flat surface with no loose bedding or soft objects through 12 months; rear-facing car seat until age 2 or the seat's height/weight limit.

Blood lead screening at 12 and 24 months for high-risk children; the CDC blood lead reference value is 3.5 mcg/dL, and no safe level exists.

Holliday–Segar hourly maintenance: 4 mL/kg/hr for the first 10 kg + 2 mL/kg/hr for the next 10 kg + 1 mL/kg/hr for each kg above 20 kg.

Daily maintenance fluid: 100 mL/kg for the first 10 kg + 50 mL/kg for the next 10 kg + 20 mL/kg for each kg above 20 kg.

Growth rules: birth weight doubles by 4–5 months and triples by 12 months; length increases about 50% by 12 months; head circumference rises about 12 cm in the first year.

Failure to thrive = weight below the 5th percentile for age or a decline crossing two or more major percentile lines; evaluate intake, absorption, and psychosocial factors.

Dehydration estimated by weight loss: under 5% mild, 5–10% moderate, over 10% severe; delayed capillary refill, tachycardia, and hypotension indicate shock.

Acute otitis media requires acute symptom onset plus middle-ear effusion plus moderate-to-severe tympanic membrane bulging or new-onset otorrhea.

Group A streptococcal pharyngitis is uncommon before age 3; diagnosis requires a rapid antigen detection test or throat culture, and routine testing is not recommended under 3 years.

Bilious emesis in a neonate is a surgical emergency until proven otherwise, most often malrotation with volvulus.

Neonatal jaundice is plotted on an hour-specific total serum bilirubin nomogram; risk category and age in hours determine phototherapy thresholds.

Bronchiolitis: supportive care only (nasal suctioning, hydration, supplemental oxygen); routine bronchodilators, corticosteroids, antibiotics, and chest radiographs are not indicated.

Acute otitis media first line: amoxicillin 80–90 mg/kg/day divided twice daily; observation is acceptable for 6–23 months with nonsevere unilateral disease and reliable follow-up.

Streptococcal pharyngitis: penicillin V or amoxicillin 50 mg/kg once daily (max 1 g) for a full 10 days; cephalexin or azithromycin for penicillin allergy.

Croup: single dose dexamethasone 0.6 mg/kg (max 10 mg); add nebulized epinephrine 1:1000, 0.5 mL/kg (max 5 mL) for stridor at rest or retractions.

Asthma: as-needed SABA at step 1; low-dose inhaled corticosteroid is the preferred step 2 controller; step therapy up or down at 2–6 week intervals based on control.

Acetaminophen 15 mg/kg every 4–6 hours (max 75 mg/kg/day, not to exceed 4 g/day); ibuprofen 10 mg/kg every 6–8 hours only in infants 6 months and older (max 40 mg/kg/day).

Kawasaki disease: IVIG 2 g/kg as a single infusion plus high-dose aspirin, started within 10 days of fever onset, reduces coronary artery aneurysm risk.

Functional constipation: PEG 3350 disimpaction at 1–1.5 g/kg/day for 3–6 days, then maintenance 0.4–0.8 g/kg/day continued for at least 2 months.

Iron deficiency anemia: elemental iron 3–6 mg/kg/day; reticulocytosis within 1–2 weeks and a hemoglobin rise by 4 weeks confirm the diagnosis.

CPNP-PC certification is granted by the Pediatric Nursing Certification Board and recertified on a 3-year cycle using continuing education, practice hours, and an exam or approved modules.

Scope of practice, prescriptive authority, and any collaborative agreement requirements derive from the state nurse practice act, not from national certification.

Suspected child abuse or neglect mandates a report to child protective services based on reasonable suspicion; proof is not required and good-faith reporters are legally protected.

Minor consent for STI care, contraception, prenatal care, and mental health or substance use treatment is set by state statute and determines parental access.

HIPAA generally permits parent access to a minor's record, but 42 CFR Part 2 and state minor-consent laws restrict disclosure of substance use and reproductive health information.

EPSDT obligates state Medicaid programs to cover periodic comprehensive screening plus all medically necessary diagnostic and treatment services for enrolled children under age 21.

VAERS accepts reports of any clinically significant adverse event after vaccination whether or not causality is established; serious events are federally reportable.

The National Childhood Vaccine Injury Act of 1986 created the Vaccine Injury Compensation Program and provided liability protection for vaccine administrators.

FERPA governs school education records while HIPAA governs covered health care entities; disclosing records between the two systems requires specific authorization.