Diabetic Ketoacidosis Flashcards
How to manage, NI?
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Maintain patent airway and oxygen administration
Maintain patent airway and oxygen adminstration =
patient exhibits Kussmaul’s Respirations which is the body’s attempt to reverse metabolic acidosis through exhalation of excess ; aids in meeting tissue oxygen needs
Establish IV Access/ Fluid electrolyte replacement
infusion of 0.9% to perfuse vital organs
0.45% to replace total body fluid loss
;to restore urine output to 30-60mL and to raise BP
replacement of sodium, chloride, bicarbonate, potassium, phosphate,nitrogen, and magnesium
Monitor glucose hourly
to determine if treatment is effective; progression of DKA, control /monitor rapid decrease of blood glucose level
Monitor I/O
fluid balance
Administer 5% dextrose added to IV fluids
administered once level is approaching 250 mg/dL to minimize cerebral edema associated with drastic changes in serum osmolality
Monitor electrolytes
To determine potassium level; Insulin drives potassium into cells leading to life threatening hypokalemia
Cardiac Monitoring/ ECG
To assess for cardiac dysrhythmia -hypo or hyper kalemia
Monitor LOC
Decreased LOC due to dehydration , electrolyte and acidosis.
Provide Reassurance
Helps decrease stress levels which may further increase blood sugar levels
Maintain Bed Rest
Decreases Metabolic Rate
Maintain Patient NPO
Placed on NPO especiallu if nausea or vomiting is present
WHAT SHOULD I REPORT TO THE PHYSICIAN?
Blood sugar level
2rep
LOC
3rep
Cardiac Changes
4rep
ABGs
5rep
Resp Status
6rep
Pain level -abdominal
7 rep
BP, Temp, Pulse
8rep
N/V
WHAT ORDERS ARE ANTICIPATED?
02
2ant
Glucose Q1HR
3ant
Labs-Electrolytes esp K+
4ant
BUN/Creatinine
