Smart Phrases And Workups – Endo

DIABETES	
#Diabetes Mellitus 2
Home meds:
*** Hgb A1c
- f/u Hgb A1c
- goal glucose 140-180 inpatient
- insulin *** + SSI

DKA	
#Diabetic Ketoacidosis
P/w
Admission BG ***, ketones ***, AG ***
Na corrected for glucose ***
- f/u Hgb A1c, BHB, ABG
- DKA protocol: insulin bolus 0.1U/kg then insulin 0.1U/kg/hr gtt
- BMP and Mg q4h, POC glucose q1h
- mIVF NS + 20 KCl, when BG <250 transition to D5NS
- NPO until AG closed x2 AND BG <200 >> then start SQ insulin | overlap IV and SQ insulin for 2-4h

HHS	
#Hyperosmolar Hyperglycmie State
-P/w
-Admission BG ***, ketones ***, AG ***
-Na corrected for glucose ***
Plan
-f/u Hgb A1c, BHB, ABG
-DKA protocol: 
--insulin bolus 0.1U/kg 
--then insulin 0.1U/kg/hr gtt
-BMP q4h
-Mg q4h
-POC glucose q1h
-mIVF NS + 20 KCl
--BG <250 
= transition to D5NS
-NPO 
-mental status improved + BG <300 
= start SQ insulin
--overlap IV and SQ insulin for 2-4h
HLD	

#SIADH	
SIADH
Etiology: CVA, CNS infection/trauma, SCC, meds (carbamazepime, opioids, cyclophosphamide, SSRIs), surgery, HIV
Admission Na:    @@@
Plan
-fluid restriction 1L/day, furosemide
-consider salt tabs 3g TID
-for severe/seizure: hypertonic NS, tolvaptan