1
Q
Diabetic ketoacidosis
A
Caused by profound deficiency of insulin
2
Q
Which type of diabetics does this affect?
A
Type 1
Rare for type 2
3
Q
DKA is characterized by
A
Hyperglycemia
Ketosis
Acidosis
Dehydration
4
Q
Precipitating factors for DKA
A
Infection Illness Inadequate insulin dosage Undiagnosed type 1 diabetes Poor self-management Neglect
5
Q
Dehydration
A
Clinical manifestation Leads to -poor skin turgor -dry mucous membranes -tachycardia -orthostatic hypotention
6
Q
Other clinical manifestations
A
Lethargy Weakness Skin dry and loose Eyes soft and sunken They will have cellular dehydration as well with complaints of abdominal cramping Anorexia, N/V Kussmaul respirations Sweet, fruit breath odor Blood glucose of 250 mg/dL or higher Blood pH lower than 7.30 (acidotic) Serum bicarbonate level lower than 16 mEq/L Positive ketone levels in urine or serum
7
Q
Ketones
A
Must be in blood before in the urine
8
Q
Hospitalized because…
A
severe fluid and electrolyte imbalance, fever, N/V, diarrhea, altered mental status
9
Q
Things to remember with insulin
A
Only give regular insulin IV
Insulin drives K into cells
-replace K below 3.5 in low doses
10
Q
Treatment
A
Ensure patent airway; administer O2 Establish a large bore IV access Begin fluid resuscitation Blood sugar management Potassium balance Acidosis management
11
Q
Acidosis management
A
Anion gap
Sodium bicarbonate if severe acidosis
12
Q
Sick day management
A
Check BG q 4 hr Notify health care provider of illness Test urine for ketones Continue with diabetic medications Unable to eat solids then drink carbohydrate content of meal Call provider -persistent N/V -moderate to LG ketones -fever
MS Module 4
flashcards
Decks in class (8)
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