PEDIAOKE by Sir Renchie Cainglet
Anticholingergics Side
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!
MI Management (MONA)
Morphine
O2 therapy
Nitropglycerine!
Aspirin
HYPOGLYCEMIA – TIRED!!!!
T – Tired Effects: 
I – Irritability (Nightmares) Can't see 
R – Restlessness Can't pee 
E – Excessive Hunger Can't spit 
(Polyphagia) Can't sh*t 
D – Depression/Diaphoresis
Hyperthyroidism (s/s)
“THYROIDISM”
HYPERNATREMIA
“You are FRIED!” Tremor
Heart rate up
F - Fever (low grade), Yawning (fatigueability)
flushed skin  Restlessness
R - Restless (irritable)  Oligomenorrhea & amenorrhea
I - Increased fluid retention Intolerance to heat
and increased BP  Diarrhea
E - Edema Irritability
(peripheral and pitting)  Sweating
D - Decreased urinary output, Muscle wasting & weight loss
dry mouth 
5W's of common causes of post-op fever 
Pressure Ulcer Staging Wind (think pneumonia, splinting,
incentive spirometer exercises not done,
Stage I erythema DB+ coughing NOT DONE) 
Stage II breakdown of the Water (dehydration...) 
dermis Wound (infection, dehiscence...) 
Stage III full thickness skin Walking (PE...) 
Breakdown Wonder drug (approriate antibiotic...) 
Stage IV bones, muscles
HEART MURMURS: SPASM!! To apply a telemetry monitor:
S Stenosis  White over right (top right shoulder)
P Partial obstruction  Black beside the white (Over lt shoulder)
A Aneurysms  Checkers (red below the black)
S Septal defect  Christmas (Green beside the red)
M Mitral regurgitation  Then ofcourse, the brown will be in the
middle!
Miotic: Little word=
Little pupil (constrict) SALT
Mydriatic: Big word=
Big pupil (dilated) S – Skin flushed
A - Agitation
L - Low-grade fever
T - Thirst
 5) All psychiatry drugs have anti R - Reduced breath sounds (&
The HYPERKALEMIA "Machine" cholinergic side effects: dypsnea) 
- Causes of Increased Serum K+ Dizziness, drowsiness, dry mouth, A - Absent fremitus 
constipation, urinary retention X - X-ray shows collapse
M - Medications - ACE inhibitors, NSAIDS
A - Acidosis - Metabolic and respiratory "CATS" of "HYPOCALCEMIA"  PNEUMONIA -  risk factors 
C - Cellular destruction - Burns, traumatic injury INSPIRATION 
H - Hypoaldosteronism, hemolysis C - Convulsions  I - Immunosuppression 
I - Intake - Excesssive A- Arrhythmias  N - Neoplasia 
N - Nephrons, renal failure T - Tetany  S - Secretion retention 
E - Excretion - Impaired S - Spasms and stridor  P - Pulmonary oedema 
I - Impaired alveolar macrophages 
R - RTI (prior) 
BLEEDING - S/Sx A - Antibiotics & cytotoxics 
Signs and Symptoms of Increased Serum BEEP T - Tracheal instrumentation 
K+: MURDER !! I - IV dug abuse 
B - Bleeding gums O - Other (general debility, immobility) 
M - Muscle weakness  E - Ecchymoses (bruises) N - Neurologic impairment of cough
U - Urine, oliguria, anuria  E - Epistaxis (nosebleed) reflex, (eg NMJ disorders)
R- Respiratory distress  P - Petechiae (tiny purplish
D - Decreased cardiac contractility  spots)
E - ECG changes  CROUP - S/Sx
R - Reflexes, hyperreflexia, or SSS
areflexia (flaccid)  S - Stridor 
TETRALOGY OF FALLOT S - Subglottic swelling 
S - Seal-bark cough
DISPLACED AORTA
HYPOKALEMIA (SUCTION) RIGHT VENTRICULAR
HYPERTROPHY
SKELETAL MUSCLE WEAKNESS OPENING INTO THE SHORTNESS OF BREATH - Causes
U-WAVE ON ECG SEPTUM (VSD) AAAA PPPP 
CONSTIPATION PULMONARY STENOSIS A - Airway obstruction 
TOXICITY TO DIGOXIN A - Angina 
IRREGULAR WEAK PULSE A - Anxiety 
OTOSTASIS RESPIRATORY DEPRESSION - A - Asthma 
NUMBNESS PARESTHESIA inducing drugs P - Pneumonia 
STOP breathing  P - Pneumothorax 
P - Pulmonary Edema 
S - Sedatives and hypnotics  P - Pulmonary Embolus
General rules regarding psychiatry T - Trimethoprim 
drugs: O - Opiates 
P - Polymyxins FEMORAL HERNIA
1) Cannot be taken with alcohol,
stimulants,depressants. FEMoral hernias are more
2) Cannot be given to pregnant, PNEUMOTHORAX - S/Sx common in FEMales.
lactatingand patients with glaucoma. P-THORAX
3) Cannot be abruptly stooped but mus P - Pleuretic pain 
be tapered slowly T - Trachea deviation 
4) All are given after meals except anti H - Hyperresonance 
anxiety agents( because food interferes O - Onset sudden 
with their absorption)
"TRY PULLING MY AORTA": Lactic acidosis
Infections "Shock, Shock, Shock,
Tricuspid Necrosis of renal tubules (ATN) Everybody Shock, Little Shock,
Pulmonary ET TUBE DELIVERABLE DRUGS Big Shock, Momma Shock,
Mitral O NAVEL: Poppa Shock":
Aorta Oxygen
Naloxone Shock= Defibrillate
Atropine Everybody= Epinephine
PLACENTA-CROSSING SUBSTANCES Ventolin (albuterol) Little= Lidocaine
"Want My Hot Dog": Epinephrine Big= Bretylium
Lidocaine Momma= MgSO4
Wastes Poppa= Pocainamide
Antibodies
Nutrients ATRIAL FIBRILLATION: CAUSES
Teratogens OF NEW ONSET VFIB/VTACH DRUGS USED
Microorganisms THE ATRIAL FIBS: ACCORDING TO ACLS
Hormones/ HIV
Drugs Thyroid "Every Little Boy Must Pray":
Hypothermia Epinephrine
Embolism (P.E.) Lidocaine
EMERGENCY MEDICINE Alcohol Bretylium
ACTIVATED CHARCOAL: Trauma (cardiac contusion) Magsulfate
CONTRAINDICATIONS Recent surgery (post CABG) Procainamide
CHEMICAL CamP: Ischemia
Atrial enlargement
Cyanide Lone or idiopathic
Hydrocarbons Fever, anemia, high-output DIABETIC KETOACIDOSIS
Ethanol states MANAGEMENT
Metals Infarct (KING UFC)
Iron Bad valves (mitral stenosis)
Caustics Stimulants (cocaine, K+ (potassium)
Airway unprotected theo, amphet, caffeine) Insulin (5u/hour. Note: sliding
Lithium scale no longer recommended
CAMphor SHOCK: S/SX in the UK)
Potassium (TV SPARC CUBE) Nasogastic tube (if patient
comatose)
Thirst Glucose (once serum levels
IPECAC: CONTRAINDICATIONS Vomiting drop to 12)
4 C's: Sweating Urea (check it)
Pulse weak Fluids (crytalloids)
Comatose Anxious Creatinine (check it)/
Convulsing Respirations shallow/rapid Catheterize
Corrosive Cool
hydroCarbon Cyanotic
Unconscious
BP low
COMPLICATIONS OF FALCIPARUM Eyes blank
MALARIA (CHAPLIN)
Cerebral malaria/ Coma Hypoglycemia
Anaemia VENTRICULAR FIBRILLATION:
Pulmonary edema TREATMENT
 Environment
NEUROLOGICAL FOCAL DEFICITS
10 S's: RLQ PAIN: DIFFERENTIAL Anorexia nervosa: clinical
APPENDICITIS: features—"ANOREXIC"
Sugar (hypo, hyper)
Stroke Appendicitis/ Abscess Adolescent women/ Amenorrhea
Seizure (Todd's paralysis) PID/ Period NGT alimentation (most severe cases)
Subdural hematoma Pancreatitis Obsession with losing weight/ becoming
Subarachnoid hemorrhage Ectopic/ Endometriosis fat though underweight
Space occupying lesion (tumor, avm, Neoplasia Refusal to eat (5% die)
aneurysm, abscess) Diverticulitis Electrolyte abnormalities (e.g., K+, cardiac
Spinal cord syndromes Intussusception arrhythmia)
Somatoform (conversion reaction) Crohns Disease/ Cyst (ovarian) X - ercise
Sclerosis (MS) IBD Intelligence often above average/ Induced
Some migraines Torsion (ovary) vomiting
Irritable Bowel Syndrome Cathartic use (and diuretic abuse)
Stones
COMA: CONDITIONS TO EXCLUDE AS
CAUSE Acid-base—"ROME" Appendicitis: assessment
(Respiratory Opposite, —"PAINS"
MIDAS: Metabolic Equal)
Meningitis Pain (RLQ)
Intoxication Acidosis Anorexia
Diabetes » Respiratory (opposite): pH Pco2 Increased temperature, WBC
Air (respiratory failure) » Metabolic(equal): pH HCO3 (15,000–20,000)
Subdural/ Subarachnoid hemorrhage Alkalosis Nausea
» Respiratory (opposite): pH Pco2 Signs (McBurney's, Psoas)
» Metabolic(equal): pH HCO3
MALIGNANT HYPERTHERMIA
TREATMENT Neurovascular Occlusion:
"Some Hot Dude Better Give Iced Fluids Alcohol withdrawal: clinical symptoms— "6 P's"
Fast!" (Hot dude = hypothermia): features—"HITS"
Pain
Stop triggering agents Hallucinations (visual, tactile) Pale
Hyperventilate/ Hundred percent oxygen Increased vital signs and Pulseless
insomnia Paresthesia
Dantrolene (2.5mg/kg) Tremens delirium tremens Poikilothermic
Bicarbonate (potentially lethal) Paralysis
Glucose and insulin Shakes/ Sweats/ Seizures/
IV Fluids and cooling blanket Stomach pains (nausea,
Fluid output monitoring/ Furosemide/ vomiting)
Fast heart [tachycardia]
Blood glucose (rhyme)
Angina: precipitating factors
—"4E's" Symptom Implication
RESUSCITATION: BASIC STEPS Eating Cold and clammy . . . give hard
ABCDE: Emotion candy
Airway Exertion (Exercise) Hot and dry . . . glucose is high
Breathing Extreme Temperatures (Hot or
Circulation Cold weather)
Drugs
 Complication of severe
Blood vessels in umbilical cord—"AVA" preeclampsia—"HELLP" Coma: causes—"A-E-I-O-U
(2 arteries and 1 vein) syndrome TIPS"

Artery Hemolysis Alcohol, acidosis (hyperglycemic coma)

Vein Elevated Liver enzymes Epilepsy (also electrolyte abnormality,
Artery Low Platelet count endocrine problem)
Insulin (hypoglycemic shock)
Overdose (or poisoning)
Cholecystitis: risk factors—"5F's" Cushing's syndrome: Uremia and other renal problems
symptoms—"3S's" Trauma; temperature abnormalities
Female (hypothermia, heat stroke)
Fat Sugar (hyperglycemia) Infection (e.g., meningitis)
Forty Salt (hypernatremia) Psychogenic ("hysterical coma")
Fertile Sex (excess androgens) Stroke or space-occupying lesions in the
Fair cranium

Cleft lip: nursing care plan Diet: low cholesterol—avoid

(postoperative)—"CLEFT LIP" the "3C's" Hypertension: complications
—"4 C's"
Crying, minimize Cake
Logan bow Cookies CAD (coronary artery disease)
Elbow restraints Cream (dairy, e.g., milk, ice CHF (congestive heart failure)
Feed with Brecht feeder cream) CRF (chronic renal failure)
Teach feeding techniques; two months CVA (cardiovascular accident;
of age (average age at repair) now called brain attack or
Liquid (sterile water), rinse after feeding stroke)
Impaired feeding (no sucking) Dystocia: etiology—"3P's"
Position—never on abdomen Powe Hypertension: nursing care
Passageway plan— "I-TIRED"
Passenger
Cognitive disorders: assessment of Intake and output (urine)
difficulties—"JOCAM" Take blood pressure
Dystocia: general aspects Ischemia attack, transient
Judgment (maternal)—"3P's" (watch for TIAs)
Orientation Respiration, pulse
Confabulation Psych Electrolytes
Affect Placenta Daily weight
Memory Position

Hypoglycemia: signs and

Diabetes: signs and symptoms—"3P's," Episiotomy assessment symptoms—"DIRE"
—"REEDA"
Diaphoresis
Polydipsia (very thirsty) Redness Increased pulse
Polyphagia (very hungry) Edema Restless
Polyuria (urinary frequency) Ecchymosis Extra hungry
Discharge
Approximation of skin
Infections during pregnancy Mental retardation: nursing Pain: assessment—"PQRST"
—"TORCH" care plan—"3R's"
What Provokes the pain?
Toxoplasmosis Regularity (provide routine and What is the Quality of the pain?
Other (hepatitis B, syphilis, group B structure) Does the pain Radiate?
beta strep) Reward (positive What is the Severity of the pain?
Rubella reinforcement) What is the Timing of the pain?
Cytomegalovirus Redundancy (repeat)
Herpes simplex virus
Pain: management—"ABCs"

IUD: potential problems with use Newborn assessment Ask about the pain
—"PAINS" components—"APGAR" Believe when clients say they have pain
Choices—let clients know their choices
Period (menstrual: late, spotting, Appearance Deliver what you can, when you said
bleeding) Pulse you would
Abdominal pain, dyspareunia Grimace Empower/Enable clients' control over
Infection (abnormal vaginal Activity pain
discharge) Respiratory effort
Not feeling well, fever or chills
String missing Postoperative complications: order
Obstetric (maternity) history —"4W's"
—"GTPAL"
Manipulation: nursing plan— Wind (pulmonary)
promote the "3C's" Gravida Wound
Term Water (urinary tract infection)
Cooperation Preterm Walk (thrombophlebitis)
Compromise Abortions (SAB, TAB)
Collaboration Living children

Preterm infant: anticipated

Medication administration—"six Oral contraceptives: signs of problems—"TRIES"
rights" potential problems—"ACHES"
Temperature regulation (poor)
RIGHT medication Abdominal pain (possible liver Resistance to infections (poor)
RIGHT dosage or gallbladder problem) Immature liver
RIGHT route Elimination problems
RIGHT time Chest pain or shortness of (necrotizing enterocolitis [NEC])
RIGHT client breath (possible pulmonary
RIGHT technique embolus) Sensory-perceptual functions
(retinopathy of prematurity
Headache (possible [ROP])
Melanoma characteristics—"ABCD" hypertension, brain attack)

Asymmetry Eye problems (possible

Border hypertension or vascular
Color accident)
Diameter
Severe leg pain (possible
thromboembolic process)
Psychotropic medications: common Traction: nursing care plan
antidepressives (tricyclics)—"VENT" —"TRACTION"
Vivactil Trapeze bar overhead to raise
Elavil and lower upper body
Norpramin Requires free-hanging weights;
Tofranil body alignment
Analgesia for pain, prn
Circulation (check color and
Schizophrenia: primary symptoms pulse)
—"4A's" Temperature (check extremity)
Infection prevention
Affect Output (monitor)
Ambivalence Nutrition (alteration related to
Associative looseness immobility)
Autism
Trauma care: complications
Sprain: nursing care plan—"RICE" —"TRAUMA"
Rest Thromboembolism; Tissue
Ice perfusion, altered
Compression Respiration, altered
Elevation Anxiety related to pain and
prognosis
Urinary elimination, altered
Stool assessment—"ACCT" Mobility impaired
Alterations in sensory-
Amount perceptual functions and skin
Color integrity (infections)
Consistency
Timing
Wernicke-Korsakoff syndrome
(alcohol-associated
Tracheoesophageal fistula: neurological disorder)—"COAT
assessment—"3Cs" RACK"
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
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)

Coughing Wernicke's encephalopathy

Choking (acute phase) Location of the heart valve
Cyanosis clinical features: from right to left - "A
Permanently Temperamental
Confusion Man"
Ophthalmoplegia
Transient ischemic attacks: Ataxia Aortic
assessment—"3Ts" Thiamine is an important aspect Pulmonary
of Tx Tricuspid
Temporary unilateral visual Mitral
impairment
Transient paralysis (one-sided) Korsakoff's psychosis (chronic
Tinnitus = vertigo phase)
 Viruses causing diarrhea - Order of prevalence of White
"Cut C4, breathe no more" "ACNE CAR" Blood Cells, most prevalent to
least - "Never Let Monkeys Eat
The 3rd, 4th and 5th cervical spinal Adeno virus Bananas"
nerves innervate the diaphragm. Corana virus
Norwak virus Neutrophils
Lymphocytes
"Point and Shoot!" Entero virus Monocytes
Calci virus Eosinophils
For remembering that Astro virus Basophils
Parasympathetics are involved with Rota virus
erection and Sympathetics with
ejaculation.
The Krebs cycle - "Can I 10 essential amino acids -
Actually See Some Filipina "PVT. TIM HALL"
Mothers"
Layers of the scalp - "SCALP" Phenylalanine
Citrate Valine
Skin Isocitrate Tryptophan
Connective tissue alpha Ketoglutarate Threonine
Aponeurosis Succinyl CoA Isoleucine
Loose areolar tissue Succinate Metheonine
Pericranium Fumarate Histidine(semi-essential)
Malate Arginine(semi-essential)
Oxaloacetate Leucine
Carpal bones of the hand (lateral to Lysine
medial) - "She Looks Too Proud, Try To
Chase Her" Stages of mitosis/meiosis
including interphase as a phase Uses of Chloroquine (other
Proximal row: - "In Philippines, Men Are than malaria) - "RED LIP"
Scaphoid Talented"
Lunate Rheumatoid arthritis
Triquetrum Interphase Extra intestinal amoebiasis
Pisiform Prophase Discoid lupus erythematosus
Metaphase Lepra reaction
Distal row: Anaphase Infectious mononucleosis
Trapezium Telophase Photogenic reactions
Trapezoid
Capitate
Hamate Signs of cor pulmonale -
"Please Read His Text" Portal hypertension features -
Bronchodilators - "TO A SIS" "ABCDE"
Peripheral edema
Terbutaline Raised JVP Ascites
Orciprenaline Hepatomegaly Bleeding (hematemesis, piles)
Adrenaline Tricuspid incompetence Caput medusae
Salbutamol Diminished liver
Isoprenaline Enlarged spleen
Salmeterol
Key questions needed in an emergency Cardinal Symptoms of LATE SIGNS OF HYPOXIA
history taking situation - "AMPLE" Parkinson's Disease - "TRAP"
BRADYCARDIA
Allergies Tremor EXTREME RESTLESSNESS
Medication Rigidity DYSPNEA
Past medical history Akinesia and bradykinesia CYANOSIS
Last meal Postural Instability
Events and environment related to
injury
Days of appearance of CONGESTIVE HEART FAILURE
rashesVaricella(chickenpox) -
Malignancies that metastisize to bone - "Very Sick Patients Must Take DIGOXIN
"Laging Panalo Kung Taga Bulacan" Double Exercise" MORPHINE
AMINOPHYLLINE
Lung 1st dayScarlet fever DOPAMINE
Prostate DIURETICS
Kidney 2nd dayPox(smallpox) O2
Thyroid GASSES – MONITOR (ABG)
Breast 3rd dayMumps

4th dayTyphus
Six "S" in Scarlet Fever MG SO4 TOXICITY
5th dayDengue
Streptococci causal organism BP DECREASE
Sorethroat 6th dayEnteric fever(typhoid) URINE OUTPUT DECREASE
Swollen tonsils RESPIRATORY RATE DECREASE
Strawberry tongue PATELLAR REFLEX ABSENT
Sandpaper rash SHOCK – HYPOTACHYTACHY
miliarySudamina vesicles over hands,
feet, abdomen
HYPOTENSION
TACHYPNEA SICKLE CELL DISEASE
Signs of anti-cholinergic crisis - "SLUD" TACHYCARDIA
HYDRATION
Salivation OXYGENATION
Lacrimation INCREASE ICP – PAIN
Urination HYPERBRADYBRADY INFECTION
Defecation AVOID HIGH PLACES
CUSHINGS TRIAD:
HYPERTENSION (WIDE PULSE
Causes of huge spleen - "3M's" PRESSURE)
BRADYCARDIA PREGNANCY INDUCED
Myelofibrosis BRADYPNEA HYPERTENSION
Malaria
Myelogenous leukemia HEMOLYSIS
EARLY SIGNS OF HYPOXIA ELEVATED LIVER ENZYMES
RESTLESSNESS LOW
AGITATION PLATELETS
TACHYCARDIA
GI SYMPTOMS AND TOXICITY ANTI TB DRUGS AND SIDE
TO DIGOXIN EFFECTS

VOMITTING
ANOREXIA RIFAMPICIN – RED-ORANGE
NAUSEA URINE
DIARRHEA
ABDOMINAL PAIN ISONIAZID – PERIPHERAL
NEURITIS

PYRAZINAMIDE – INCREASE
FRACTURE URIC ACID

PRESSURE ETHAMBUTOL – EYE PROBLEMS

REST
ICE STREPTOMYCIN – OTOTOXIC
COMPRESSION
ELEVATION

USE STRAW BECAUSE THESE

DRUGS STAIN THE TEETH
NEUROVASCULAR CHECK
L - LUGOL'S SOLUTION
PAIN I - IRON
PULSELESSNESS N - NITROFURANTOIN
PARESTHESIA T - TETRACYCLINE
PARALYSIS
PALLOR
LR6 - LATERAL RECTUS : CN6

SO4 - SUPERIOR OBLIQUE : CN4

VIRCHOW’S TRIAD IN DVT ALL3 - ALL THE REST : CN3

VENUS STASIS
DAMAGE TO VESSELS RADIATION TX VIA:
HYPERCOAGUABILITY MUSTARD
ESTROGEN
NITROGEN
STEROIDS
ABDOMINAL AORTIC ANTIBIOTICS
ANEURISM (4A)

ASSYMPTOMATIC
ABDOMINAL MASS DILUTE DECREASE
ABDOMINAL PULSE OSMOLALITY
ACHES LOW BACK