Diabetic Ketoacidosis (DKA) Flashcards
what is diabetic ketoacidosis (DKA)?
severe hypergylcaemia
symptoms of DKA
-polyurea
-thirsty
-peardrop breath smells (ketones)
-deep or fast breathing
-lethargy/unconcious
-confusion
What needs to be monitored in DKA
Blood sugar if symptoms of DKA
what to do if blood sugar levels are higher than 11mmol/l
check ketones levels in urine and blood
what to do if blood sugar levels are 5-1.5mmol
slight risk retest in 2hr
what to do if blood sugar levels are 1.6-2.9mmol
high risk inform GP
what to do if blood sugar levels are 3+mmol/l
medical emergency
7 steps
DKA tx
1) if BP < 90 restore vol with 500mL IV NaCl 0.9%
2) if bp > 90 maintenance IV NaCl 0.9%
3) start IV insulin mixed with NaCl + adminster at a rate so that ketone conc falls at 0.5mmol/hr and blood glucose conc falls at 3mmol/hr
4) if blood glucose < 14mmol/l give IV glucose 10%
5) continue insulin till ketone <0/3mmol/l and pH > 7.3
6) when pt can eat give fasting acting insulin with meals
7) STOP tx 1hr after food