PEDIAOKE by Sir Renchie Cainglet Tila INFANT kung maglaro Solitary lagi, Stranger anxiety Weaning 6 months Aspiration

risk precaution On TODDLERHOOD naman Nega at Tantrums ginagawa Separation PRODESDEN May physio-logic anorexia pa Push pull toys like tarak tarak Autonomy vs. Shame and Doubt First dental visit ay 2 and a half Risk for poisoning problema jan PRESCHOOL naman ay PHALLIC Associative Play lagi ang gimik Common fear is mutilation Fear of dark and ghost din yun Behavior ay gender specific At may magi-cal thinking Ang patay is sleeping Initiative vs. guilt Ang SCHOOL AGE latent yan Concrete thinking, Logic reasoning Same sex stage, normal na bading Heroworship and plays competitive Schooler starts to have a bestfriend Takot parati control niya ay mag end Permanent ang concept of death Industry vs inferiority Formal ang adolescent Sa body image may disturbance Ang thelarche ang first sign sa girls At last sign yan ang menarche!

HYPOGLYCEMIA TIRED!!!! T Tired I Irritability (Nightmares) R Restlessness E Excessive Hunger (Polyphagia) D Depression/Diaphoresis

Anticholingergics Side Effects: Can't see Can't pee Can't spit Can't sh*t

Hyperthyroidism (s/s) THYROIDISM HYPERNATREMIA You are FRIED! F - Fever (low grade), flushed skin R - Restless (irritable) I - Increased fluid retention and increased BP E - Edema (peripheral and pitting) D - Decreased urinary output, dry mouth Tremor Heart rate up Yawning (fatigueability) Restlessness Oligomenorrhea & amenorrhea Intolerance to heat Diarrhea Irritability Sweating Muscle wasting & weight loss 5W's of common causes of post-op fever Pressure Ulcer Staging Stage I erythema Stage II breakdown of the dermis Stage III full thickness skin Breakdown Stage IV bones, muscles Wind (think pneumonia, splinting, incentive spirometer exercises not done, DB+ coughing NOT DONE) Water (dehydration...) Wound (infection, dehiscence...) Walking (PE...) Wonder drug (approriate antibiotic...)

HEART MURMURS: SPASM!! S Stenosis P Partial obstruction A Aneurysms S Septal defect M Mitral regurgitation

To apply a telemetry monitor: White over right (top right shoulder) Black beside the white (Over lt shoulder) Checkers (red below the black) Christmas (Green beside the red) Then ofcourse, the brown will be in the middle!

MI Management (MONA) Morphine O2 therapy Nitropglycerine! Aspirin Miotic: Little word= Little pupil (constrict) Mydriatic: Big word= Big pupil (dilated) SALT S Skin flushed A - Agitation L - Low-grade fever T - Thirst

Bleeding gums E .IV dug abuse O .Stridor S .Decreased cardiac contractility E .Urine.Excretion . renal failure S .Tracheal instrumentation I .Respiratory distress D . dry mouth.Cellular destruction .Airway obstruction A .Intake .Asthma P .Hyperresonance O . PNEUMOTHORAX . (eg NMJ disorders) Signs and Symptoms of Increased Serum K+: MURDER !! M .5) All psychiatry drugs have anti cholinergic side effects: Dizziness.Hypoaldosteronism.Onset sudden .depressants.Trimethoprim O .RTI (prior) A . 3) Cannot be abruptly stooped but mus be tapered slowly 4) All are given after meals except anti anxiety agents( because food interferes with their absorption) FEMORAL HERNIA FEMoral hernias are more common in FEMales.Pulmonary Embolus General rules regarding psychiatry drugs: 1) Cannot be taken with alcohol. 2) Cannot be given to pregnant.ACE inhibitors.S/Sx SSS S .Causes of Increased Serum K+ R .risk factors INSPIRATION I .ECG changes R .Pneumonia P .Secretion retention P .Other (general debility.Anxiety A . constipation. hemolysis A.X-ray shows collapse PNEUMONIA .Impaired alveolar macrophages R .Arrhythmias I .Medications . urinary retention M .Polymyxins SHORTNESS OF BREATH .Ecchymoses (bruises) E .Pleuretic pain T .Antibiotics & cytotoxics T .Pulmonary oedema I .Causes AAAA PPPP A . traumatic injury C .Convulsions H .Acidosis . immobility) N .Burns.Sedatives and hypnotics T .Neoplasia S . NSAIDS "CATS" of "HYPOCALCEMIA" A .Seal-bark cough HYPOKALEMIA (SUCTION) SKELETAL MUSCLE WEAKNESS U-WAVE ON ECG CONSTIPATION TOXICITY TO DIGOXIN IRREGULAR WEAK PULSE OTOSTASIS NUMBNESS PARESTHESIA RESPIRATORY DEPRESSION inducing drugs STOP breathing S . anuria R.Subglottic swelling S . stimulants.Epistaxis (nosebleed) P .Metabolic and respiratory C .S/Sx BEEP B . oliguria.Pneumothorax P . or areflexia (flaccid) BLEEDING . drowsiness.Trachea deviation H .S/Sx P-THORAX P .Reflexes.Petechiae (tiny purplish spots) TETRALOGY OF FALLOT DISPLACED AORTA RIGHT VENTRICULAR HYPERTROPHY OPENING INTO THE SEPTUM (VSD) PULMONARY STENOSIS CROUP .Immunosuppression N .Spasms and stridor E . lactatingand patients with glaucoma. hyperreflexia.Excesssive T .Angina A .Opiates P .Muscle weakness U .Neurologic impairment of cough reflex.Tetany N .Absent fremitus X .Pulmonary Edema P .Nephrons.Reduced breath sounds (& dypsnea) A .Impaired The HYPERKALEMIA "Machine" .

Little Shock. Big Shock.) Alcohol EMERGENCY MEDICINE Trauma (cardiac contusion) ACTIVATED CHARCOAL: Recent surgery (post CABG) CONTRAINDICATIONS Ischemia CHEMICAL CamP: Atrial enlargement Lone or idiopathic Cyanide Fever.E. anemia. Momma Shock. Shock. Caustics theo. caffeine) Airway unprotected Lithium SHOCK: S/SX CAMphor (TV SPARC CUBE) Potassium Thirst Vomiting Sweating Pulse weak Anxious Respirations shallow/rapid Cool Cyanotic Unconscious BP low Eyes blank "Shock. amphet. high-output Hydrocarbons states Ethanol Infarct Metals Bad valves (mitral stenosis) Iron Stimulants (cocaine. Poppa Shock": Shock= Defibrillate Everybody= Epinephine Little= Lidocaine Big= Bretylium Momma= MgSO4 Poppa= Pocainamide VFIB/VTACH DRUGS USED ACCORDING TO ACLS "Every Little Boy Must Pray": Epinephrine Lidocaine Bretylium Magsulfate Procainamide DIABETIC KETOACIDOSIS MANAGEMENT (KING UFC) K+ (potassium) Insulin (5u/hour."TRY PULLING MY AORTA": Lactic acidosis Infections Tricuspid Necrosis of renal tubules (ATN) Pulmonary ET TUBE DELIVERABLE DRUGS Mitral O NAVEL: Aorta Oxygen Naloxone Atropine Ventolin (albuterol) PLACENTA-CROSSING SUBSTANCES Epinephrine "Want My Hot Dog": Lidocaine Wastes Antibodies ATRIAL FIBRILLATION: CAUSES Nutrients OF NEW ONSET Teratogens THE ATRIAL FIBS: Microorganisms Hormones/ HIV Thyroid Drugs Hypothermia Embolism (P. Everybody Shock. Note: sliding scale no longer recommended in the UK) Nasogastic tube (if patient comatose) Glucose (once serum levels drop to 12) Urea (check it) Fluids (crytalloids) Creatinine (check it)/ Catheterize IPECAC: CONTRAINDICATIONS 4 C's: Comatose Convulsing Corrosive hydroCarbon COMPLICATIONS OF FALCIPARUM MALARIA (CHAPLIN) Cerebral malaria/ Coma Hypoglycemia Anaemia Pulmonary edema VENTRICULAR FIBRILLATION: TREATMENT . Shock.

tactile) Increased vital signs and insomnia Tremens delirium tremens (potentially lethal) Shakes/ Sweats/ Seizures/ Stomach pains (nausea. . avm.000 20.. vomiting) Pain Pale Pulseless Paresthesia Poikilothermic Paralysis Blood glucose (rhyme) Angina: precipitating factors "4E's" Eating Emotion Exertion (Exercise) Extreme Temperatures (Hot or Cold weather) Symptom Implication Cold and clammy . . WBC (15.NEUROLOGICAL FOCAL DEFICITS 10 S's: Sugar (hypo.ercise Intelligence often above average/ Induced vomiting Cathartic use (and diuretic abuse) COMA: CONDITIONS TO EXCLUDE AS CAUSE MIDAS: Meningitis Intoxication Diabetes Air (respiratory failure) Subdural/ Subarachnoid hemorrhage Appendicitis: assessment "PAINS" Pain (RLQ) Anorexia Increased temperature. abscess) Spinal cord syndromes Somatoform (conversion reaction) Sclerosis (MS) Some migraines RLQ PAIN: DIFFERENTIAL APPENDICITIS: Appendicitis/ Abscess PID/ Period Pancreatitis Ectopic/ Endometriosis Neoplasia Diverticulitis Intussusception Crohns Disease/ Cyst (ovarian) IBD Torsion (ovary) Irritable Bowel Syndrome Stones Acid-base "ROME" (Respiratory Opposite. give hard candy Hot and dry .5mg/kg) Bicarbonate Glucose and insulin IV Fluids and cooling blanket Fluid output monitoring/ Furosemide/ Fast heart [tachycardia] Neurovascular Occlusion: symptoms "6 P's" Alcohol withdrawal: clinical features "HITS" Hallucinations (visual. Metabolic Equal) Acidosis » Respiratory (opposite): pH Pco2 » Metabolic(equal): pH HCO3 Alkalosis » Respiratory (opposite): pH Pco2 » Metabolic(equal): pH HCO3 Anorexia nervosa: clinical features "ANOREXIC" Adolescent women/ Amenorrhea NGT alimentation (most severe cases) Obsession with losing weight/ becoming fat though underweight Refusal to eat (5% die) Electrolyte abnormalities (e.000) Nausea Signs (McBurney's. . hyper) Stroke Seizure (Todd's paralysis) Subdural hematoma Subarachnoid hemorrhage Space occupying lesion (tumor. glucose is high RESUSCITATION: BASIC STEPS ABCDE: Airway Breathing Circulation Drugs Environment .g. . Psoas) MALIGNANT HYPERTHERMIA TREATMENT "Some Hot Dude Better Give Iced Fluids Fast!" (Hot dude = hypothermia): Stop triggering agents Hyperventilate/ Hundred percent oxygen Dantrolene (2. cardiac arrhythmia) X . K+. aneurysm.

. endocrine problem) Insulin (hypoglycemic shock) Overdose (or poisoning) Uremia and other renal problems Trauma. now called brain attack or stroke) Hypertension: nursing care plan "I-TIRED" Intake and output (urine) Take blood pressure Ischemia attack. minimize Logan bow Elbow restraints Feed with Brecht feeder Teach feeding techniques. ice cream) Hypertension: complications "4 C's" CAD (coronary artery disease) CHF (congestive heart failure) CRF (chronic renal failure) CVA (cardiovascular accident. meningitis) Psychogenic ("hysterical coma") Stroke or space-occupying lesions in the cranium Cholecystitis: risk factors "5F's" Female Fat Forty Fertile Fair Cushing's syndrome: symptoms "3S's" Sugar (hyperglycemia) Salt (hypernatremia) Sex (excess androgens) Cleft lip: nursing care plan (postoperative) "CLEFT LIP" Crying. milk.. e. pulse Electrolytes Daily weight Dystocia: etiology "3P's" Powe Passageway Passenger Cognitive disorders: assessment of difficulties "JOCAM" Judgment Orientation Confabulation Affect Memory Dystocia: general aspects (maternal) "3P's" Psych Placenta Position Diabetes: signs and symptoms "3P's. temperature abnormalities (hypothermia." Episiotomy assessment "REEDA" Redness Edema Ecchymosis Discharge Approximation of skin Hypoglycemia: signs and symptoms "DIRE" Diaphoresis Increased pulse Restless Extra hungry Polydipsia (very thirsty) Polyphagia (very hungry) Polyuria (urinary frequency) . heat stroke) Infection (e. two months of age (average age at repair) Liquid (sterile water). rinse after feeding Impaired feeding (no sucking) Position never on abdomen Diet: low cholesterol avoid the "3C's" Cake Cookies Cream (dairy.Blood vessels in umbilical cord "AVA" (2 arteries and 1 vein) Artery Vein Artery Complication of severe preeclampsia "HELLP" syndrome Hemolysis Elevated Liver enzymes Low Platelet count Coma: causes "A-E-I-O-U TIPS" Alcohol. acidosis (hyperglycemic coma) Epilepsy (also electrolyte abnormality.g.g. transient (watch for TIAs) Respiration.

group B beta strep) Rubella Cytomegalovirus Herpes simplex virus Mental retardation: nursing care plan "3R's" Regularity (provide routine and structure) Reward (positive reinforcement) Redundancy (repeat) Pain: assessment "PQRST" What Provokes the pain? What is the Quality of the pain? Does the pain Radiate? What is the Severity of the pain? What is the Timing of the pain? Pain: management "ABCs" IUD: potential problems with use "PAINS" Period (menstrual: late. brain attack) Eye problems (possible hypertension or vascular accident) Severe leg pain (possible thromboembolic process) Preterm infant: anticipated problems "TRIES" Temperature regulation (poor) Resistance to infections (poor) Immature liver Elimination problems (necrotizing enterocolitis [NEC]) Sensory-perceptual functions (retinopathy of prematurity [ROP]) Melanoma characteristics "ABCD" Asymmetry Border Color Diameter . syphilis. TAB) Living children Postoperative complications: order "4W's" Wind (pulmonary) Wound Water (urinary tract infection) Walk (thrombophlebitis) Medication administration "six rights" RIGHT medication RIGHT dosage RIGHT route RIGHT time RIGHT client RIGHT technique Oral contraceptives: signs of potential problems "ACHES" Abdominal pain (possible liver or gallbladder problem) Chest pain or shortness of breath (possible pulmonary embolus) Headache (possible hypertension. spotting. when you said you would Empower/Enable clients' control over pain Obstetric (maternity) history "GTPAL" Manipulation: nursing plan promote the "3C's" Cooperation Compromise Collaboration Gravida Term Preterm Abortions (SAB. dyspareunia Infection (abnormal vaginal discharge) Not feeling well. bleeding) Abdominal pain.Infections during pregnancy "TORCH" Toxoplasmosis Other (hepatitis B. fever or chills String missing Newborn assessment components "APGAR" Appearance Pulse Grimace Activity Respiratory effort Ask about the pain Believe when clients say they have pain Choices let clients know their choices Deliver what you can.

altered Respiration. altered Anxiety related to pain and prognosis Urinary elimination. body alignment Analgesia for pain. altered Mobility impaired Alterations in sensoryperceptual functions and skin integrity (infections) FOCUS OF PATIENT CARE IN CLIENTS WITH CANCER Chemotherapy Assess body image disturbance (related to alopecia) Nutritional needs when N/V present Comfort from pain Effective response to Tx? (Evaluate) Rest (for patient and family) Stool assessment "ACCT" Amount Color Consistency Timing Tracheoesophageal fistula: assessment "3Cs" Coughing Choking Cyanosis Wernicke-Korsakoff syndrome (alcohol-associated neurological disorder) "COAT RACK" Wernicke's encephalopathy (acute phase) clinical features: Confusion Ophthalmoplegia Ataxia Thiamine is an important aspect of Tx Location of the heart valve from right to left ."A Permanently Temperamental Man" Aortic Pulmonary Tricuspid Mitral Transient ischemic attacks: assessment "3Ts" Temporary unilateral visual impairment Transient paralysis (one-sided) Tinnitus = vertigo Korsakoff's psychosis (chronic phase) . Tissue perfusion.Psychotropic medications: common antidepressives (tricyclics) "VENT" Vivactil Elavil Norpramin Tofranil Traction: nursing care plan "TRACTION" Trapeze bar overhead to raise and lower upper body Requires free-hanging weights. prn Circulation (check color and pulse) Temperature (check extremity) Infection prevention Output (monitor) Nutrition (alteration related to immobility) characteristic findings: Retrograde amnesia (recall of some old memories) Anterograde amnesia (ability to form new memories) Confabulation Korsakoff's psychosis SIGNS OF CANCER Change in bowel /bladder habits A sore that doesn t heal Unusual bleeding/ Discharge Thickening of lump breast or elsewhere Indigestion/ Dysphagia Obvious change in wart/ mole Nagging cough/ hoarseness Unexplained anemia Sudden weight loss Schizophrenia: primary symptoms "4A's" Affect Ambivalence Associative looseness Autism Sprain: nursing care plan "RICE" Rest Ice Compression Elevation Trauma care: complications "TRAUMA" Thromboembolism.

"Can I Actually See Some Filipina Mothers" Layers of the scalp . piles) Caput medusae Diminished liver Enlarged spleen . Try To Chase Her" Proximal row: Scaphoid Lunate Triquetrum Pisiform Distal row: Trapezium Trapezoid Capitate Hamate Bronchodilators ."TO A SIS" Terbutaline Orciprenaline Adrenaline Salbutamol Isoprenaline Salmeterol Stages of mitosis/meiosis including interphase as a phase . The Krebs cycle . breathe no more" The 3rd. 4th and 5th cervical spinal nerves innervate the diaphragm. TIM HALL" Phenylalanine Valine Tryptophan Threonine Isoleucine Metheonine Histidine(semi-essential) Arginine(semi-essential) Leucine Lysine Carpal bones of the hand (lateral to medial) ."In Philippines."RED LIP" Rheumatoid arthritis Extra intestinal amoebiasis Discoid lupus erythematosus Lepra reaction Infectious mononucleosis Photogenic reactions Signs of cor pulmonale "Please Read His Text" Peripheral edema Raised JVP Hepatomegaly Tricuspid incompetence Portal hypertension features "ABCDE" Ascites Bleeding (hematemesis. most prevalent to least ."Cut C4. Men Are Talented" Interphase Prophase Metaphase Anaphase Telophase Uses of Chloroquine (other than malaria) ."SCALP" Skin Connective tissue Aponeurosis Loose areolar tissue Pericranium Citrate Isocitrate alpha Ketoglutarate Succinyl CoA Succinate Fumarate Malate Oxaloacetate 10 essential amino acids "PVT."She Looks Too Proud."Never Let Monkeys Eat Bananas" Neutrophils Lymphocytes Monocytes Eosinophils Basophils "Point and Shoot!" For remembering that Parasympathetics are involved with erection and Sympathetics with ejaculation. Viruses causing diarrhea "ACNE CAR" Adeno virus Corana virus Norwak virus Entero virus Calci virus Astro virus Rota virus Order of prevalence of White Blood Cells.

"AMPLE" Allergies Medication Past medical history Last meal Events and environment related to injury Cardinal Symptoms of Parkinson's Disease . feet."TRAP" Tremor Rigidity Akinesia and bradykinesia Postural Instability LATE SIGNS OF HYPOXIA BRADYCARDIA EXTREME RESTLESSNESS DYSPNEA CYANOSIS Malignancies that metastisize to bone "Laging Panalo Kung Taga Bulacan" Lung Prostate Kidney Thyroid Breast Days of appearance of rashesVaricella(chickenpox) "Very Sick Patients Must Take Double Exercise" 1st dayScarlet fever 2nd dayPox(smallpox) 3rd dayMumps 4th dayTyphus CONGESTIVE HEART FAILURE DIGOXIN MORPHINE AMINOPHYLLINE DOPAMINE DIURETICS O2 GASSES MONITOR (ABG) Six "S" in Scarlet Fever 5th dayDengue Streptococci causal organism Sorethroat Swollen tonsils Strawberry tongue Sandpaper rash miliarySudamina vesicles over hands."3M's" Myelofibrosis Malaria Myelogenous leukemia PREGNANCY INDUCED HYPERTENSION HEMOLYSIS ELEVATED LIVER ENZYMES LOW PLATELETS EARLY SIGNS OF HYPOXIA RESTLESSNESS AGITATION TACHYCARDIA . abdomen 6th dayEnteric fever(typhoid) MG SO4 TOXICITY BP DECREASE URINE OUTPUT DECREASE RESPIRATORY RATE DECREASE PATELLAR REFLEX ABSENT SHOCK HYPOTACHYTACHY Signs of anti-cholinergic crisis ."SLUD" Salivation Lacrimation Urination Defecation HYPOTENSION TACHYPNEA TACHYCARDIA SICKLE CELL DISEASE HYDRATION OXYGENATION PAIN INFECTION AVOID HIGH PLACES INCREASE ICP HYPERBRADYBRADY CUSHINGS TRIAD: HYPERTENSION (WIDE PULSE PRESSURE) BRADYCARDIA BRADYPNEA Causes of huge spleen .Key questions needed in an emergency history taking situation .