48 pneumonics

Chapter 48 Pneumonics: Alteration in Metabolism and Endocrine Disorders

Diabetes Mellitus Type 1

3 P's = Polyuria, Polydipsia, Polyphagia

DKA Signs

DKA = Dehydration, Kussmaul breathing, Acidosis

DKA Treatment Order

FINS = Fluids, Insulin, Normalize electrolytes, Sugar correction slowly

Hypoglycemia

TIRED = Tachycardia, Irritability, Restless, Excessive hunger, Diaphoresis/Depression

Hyperglycemia

3 P’s + Hot and Dry = Sugar High

Diabetes Sick Day Rules

SICK = Sugar check q3h, Insulin as prescribed, Carbs + fluids, Ketone check q3h

Hypopituitarism

LAG = Low growth hormone, Age-inappropriate size, Growth chart falling off

Growth Hormone Replacement

GROW = Given at bedtime, Rotate injection site, Observe for limp/joint pain, Watch growth chart

Precocious Puberty

PUBERTY = Pubic hair early, Unusual growth spurt, Behavior changes, Estrogen/testosterone ↑, Refer endocrinology, Treatment: Lupron, Yearly follow-up

Congenital Hypothyroidism

THYROID = Tongue large, Hypotonia, Yellow skin, Retardation prevention (early meds), Output low, Increased fontanels, Dry skin

Levothyroxine Teaching

DAILY = Don’t skip doses, Administer in morning, Iodine interaction caution, Life-long therapy, You’ll monitor TSH

Hyperthyroidism (Graves)

FAST = Fast HR, Appetite up, Sweaty skin, Tremor

PTU/Methimazole Caution

WBC = Watch for fever, Bruising, Count blood (agranulocytosis risk)

Cushing’s Syndrome

CUSHING = Central obesity, Unusual hair growth, Striae, Hyperglycemia, Infection risk, Na+↑, Growth delays

Addison’s Disease

ADDISON = Apathy, Dark skin, Drop BP, Insufficient cortisol, Salt craving, Ongoing fatigue, N/V

Adrenal Crisis

5 S’s = Sudden pain, Syncope, Shock, Severe vomiting, Salt craving

PKU Diet

PAUSE = Protein limit, Avoid high phenylalanine, Use special formula, Screen newborns, Educate on labels

Turner Syndrome

TURNER = Tiny stature, Underdeveloped ovaries, Renal/heart defects, Neck webbing, Estrogen therapy, Reassure girl

Congenital Adrenal Hyperplasia

CAH = Clitoral enlargement, Ambiguous genitalia, High 17-ketosteroids