48 - DKA

Question 1

DKA is caused by..

Answer 1

insulin deficiency
hyperglycemia

Question 2

DKA is characterized by

Answer 2

-hyperglycemia
-ketosis
-acidosis
-dehydration

Question 3

DKA precipitating factors

Answer 3

-illness
-infection
-inadequate insulin dosage
-undiagnsoed DMT1
-neglect

Question 4

Ketones

Answer 4

compensatory breakdown of fat
-acidic

Question 5

Insulin deficiency on protein synthesis

Answer 5

-impairs protein synth
-»»>.leads to nitrogen losses fr tissue
-production of glucose fr proteins + liver
»»more hyperglycemia
»>adds to osmotic diuresis

Question 6

insulin deficiency on electrolyte imbalance

Answer 6

-depletion
Na, K, Cl, Mgm phosphate

Question 7

dehydration in DKA

Answer 7

-dry mucous membranes
-tachycardia
-orthostatic hypotension

Question 8

early s/s

Answer 8

lethargy + weakness

Question 9

late signs of dehydration

Answer 9

-skin is dry + loose
-eyes soft + sunken
-ab pain w anorexia, n/v

Question 10

kussmaul resp

Answer 10

rapid deep + dyspnea

-attempt to reverse metab acidosis

Question 11

diagnostics for DKA

BLOOD GLUC
pH
SERUM BICARB
URINE

Answer 11

BLOOD GLUC - >250mg/dL
pH - <7.30
SERUM BICARB - <16mEq/L
URINE - mod to large ketones present

Question 12

if DKA w PNA + UTI…

Answer 12

then admit to hospital

Question 13

first goal of therapy

Answer 13

establish IV access
-admin fluid + electrolyte replacement

Question 14

preferred fluids for IV

Answer 14

0.45-0.9 NaCl

Question 15

when blood gluc is approaching 250…

Answer 15

add 5-10% dextrose
-to prevent hypoglycemia

Question 16

continue IV infusion until…

Answer 16

BP is raised + UO is to 30-60mL/hr

Question 17

fast drop in glucose can lead to

Answer 17

cerebral edema

Question 18

before giving insulin….

Answer 18

obtain serum K level

Question 19

blood glucose reduction
safe speed

Answer 19

36-54 mg/dL/hr