DKA Flashcards
Which type of diabetes is typically associated with DKA?
Type 1
What does the anion gap tell you?
differential causes of metabolic acidosis
What does a high anion gap mean?
acid accumulation –> in the case of DKA…
Ketoacidosis
DKA three main causes
- decreased or missed dose of insulin
- undiagnosed or untreated T1D
- illness or infection
Other causes of DKA (6)
- patient error in drawing up Or injecting insulin
- intentional skipping of insulin doses
- equipment problems
- severe stress- trauma, surgery, AMI
- excessive exercise
- pregnancy in T1D
DKA Clinical manifestations (10)
- polyuria
- polydipsia
- polyphagia
- fatigue or weakness
- orthostatic hypotension, weak-rapid pulse
- hyperventilation/ Kussmaul respirations
- abdominal pain
- anorexia, N/V
- fruity odor to breath
- lethargy/ALOC
DKA Assessment/diagnostic findings (7)
- blood glucose: 300-80 ml/dl (up to 1000)
- decreased serum bicarb: 0-15
- decreased pH: 6.8-7.3
- decreased PaCO2 (10-30)
- Na and K+ may be low, normal, or high (depends on water loss)
- increased creatinine, BUN and hematocrit
- increased serum osmolality: 300-320
which lab level is used to differentiate between DKA and HHS
serum osmolality
Which fluid is usually given first for the patient in DKA?
Normal saline
When BG is < 300 mg/dl, which fluid is used? why?
D5W to prevent a huge drop in DG
Which electrolyte must be assessed before starting insulin IV Drip? What is the value it must be at
K+, greater than 3.3 mEq/L
How is acidosis reduced in DKA?
insulin
Which type of insulin is given to reverse acidosis?
Regular insulin only!
How quickly is insulin given IV to reverse acidosis?
slow, continuous rate
How often is BG checked when pt is on insulin drip?
q 1 hr
