18.8.2013(DKA) Flashcards
When is 10%D administered to DKA pt?
When blood glucose level reaches 250mg/dl
Precipitating factors for DKA
Infection CVA MI DVT sepsis Trauma Pregnancy
Fluid resuscitation in DKA
1-3L in 1st hour
1L in 2nd hour
1L in 3rd and 4th hour
1L every 4hrs
When should insulin treatment be started in DKA
After an hour of IV fluid replacement
Route of administration of insulin in DKA
I.m or IV
Subcutaneous absorption is reduced because of dehydration
Fluid after 180mg/dl glucose is reached
5-10%D+ 0.45N Nacl
causes of Euglycemic DKA
pregnancy
alcoholism
Average degree of dehydration in DKA pts
8-9% of body weight
amount of Fluid loss if hypotension is present in DKA
10% of body weight
Appropriate decrease in blood glucose in DKA
50-75 mg%/h
osmotic encephalopathy is a possibility if glucose is corrected at a rate more than
100 mg/dl/h
Contraindications to routine K+ replacement in DKA
K+ more than 6 mmol/L
ECG evidence of hyperkalemia
oliguria confirmed by bladder catheterisation
renal failure
Bicarbonate therapy in DKA
Shock or coma
pH< 5 mEq/L
acidosis induced cardiac or respiratory dysfunction
severe hyperkalemia
Magnesium therapy in DKA
ventricular arrythmias
Complications of DKA
Arterial Thrombosis
Cerebral edema
Lactic acidosis
Rebound DKA