DKA Flashcards

1
Q

what is DKA?

A

-life-threatening complication of diabetes associated with ketosis, hyperglycemia & metabolic acidosis

-elevated glucose levels, decreased pH, decreased serum bicarb, elevated ketones, & dehydration

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1
Q

who is DKA most common in?

A

T1DM

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2
Q

precipitating factors of DKA

A

-illness
-stress
-trauma
-infection
-N/V
-new onset of T1DM

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3
Q

typical BG levels with DKA

A

250-600

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4
Q

DKA risk factors

A

-history of type 1 DM
-40+
-pregnancy
-condtions that cause extreme stress
-SES factors
-cocaine usage’-treatment plan non adherence

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5
Q

DKA S/Sx

A

-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

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6
Q

Diagnostic tests

A

-fingerstick BG
-ABG
-CBC with differential
-preg test
-BMP
-ketones
-betahydroxybutyrate

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7
Q

betahydroxybutyrate

A

-trends with patient’s clinical status
-most predominate for ketone presence during DKA
->.5 indication of ketones
-treat at 3
-<.4 is normal

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8
Q

other lab values

A

-normal to high potassium
-low serum osmolality
-high anion gap

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9
Q

DKA treatment

A

-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

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10
Q

how much insulin in DKA?

A

0.1 units/kg/1hr

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11
Q

how often are you checking BG during DKA treatment?

A

every 1 hour

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12
Q

is potassium a vesicant?

A

yes, prefer centra line

also can slow down if hurts patient

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13
Q

how often do you test for ketones?

A

every 2-3 hours

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