DKA Flashcards
what is DKA?
-life-threatening complication of diabetes associated with ketosis, hyperglycemia & metabolic acidosis
-elevated glucose levels, decreased pH, decreased serum bicarb, elevated ketones, & dehydration
who is DKA most common in?
T1DM
precipitating factors of DKA
-illness
-stress
-trauma
-infection
-N/V
-new onset of T1DM
typical BG levels with DKA
250-600
DKA risk factors
-history of type 1 DM
-40+
-pregnancy
-condtions that cause extreme stress
-SES factors
-cocaine usage’-treatment plan non adherence
DKA S/Sx
-acute onset usually under 24 hrs
-signs/sx related to hyperglycemia
-hypotension
-tachycardia
-signs of dehydration
-abdominal pain, nausea, vomiting
-fruity/acetone breath
-Kussmaul breathing
-mental status changes
Diagnostic tests
-fingerstick BG
-ABG
-CBC with differential
-preg test
-BMP
-ketones
-betahydroxybutyrate
betahydroxybutyrate
-trends with patient’s clinical status
-most predominate for ketone presence during DKA
->.5 indication of ketones
-treat at 3
-<.4 is normal
other lab values
-normal to high potassium
-low serum osmolality
-high anion gap
DKA treatment
-hydration, NS or LR (hypotonic is Na2+ is elevated)
-change to dextrose soln
-insulin drip (regular)
-potassium repletion
-continue treatment until anion gap is closed
how much insulin in DKA?
0.1 units/kg/1hr
how often are you checking BG during DKA treatment?
every 1 hour
is potassium a vesicant?
yes, prefer centra line
also can slow down if hurts patient
how often do you test for ketones?
every 2-3 hours