DKA 2 - Mx

Question 1

Immediate treatment;
?.
?L ? ? over ? hour if SBP >?.
o ?ml over ? mins if SBP , re-assess & repeat if poor response

Answer 1

A_E
1
normal saline
1
90
500
10
90

Question 2

Immediate

Start ? ? ?.
o ? units human soluble ? ? added to ?ml 0.9% sodium chloride giving a ? unit/ml solution .
o Start in ? ? at ? units/kg/hour (can use estimated weight) .

Answer 2

iv insulin infusion
50
actrapid insulin
50
1
syringe driver
0.1

Question 3

Get urgent ? ? review if severe DKA, drowsy, ?, sats % on 40% O2 or persistent hypotension ( SBP) after ?L of sodium chloride .

Answer 3

crit care
preg
94
90
2

Question 4

Further trt
Continue ? rate insulin at ? units/kg/hour, and continue normal ? acting insulin.
o Aim for blood glucose fall of >?mmol/L/hour until under ?mmol/L.
• If not glucose is not falling, check ?, ? operation,
patient ?, reassess concomitant ?.
• Increase rate by ? unit/ hour every hour if necessary.

Answer 4

fixed
0.1
long
3
14
dosage
pump
wt
illness
1

Question 5

Continue IV 0.9% sodium chloride.
o First bag: ?L over ? hour.
o Second bag: ?L over ? hours.
• Consider ? from second bag onwards (see below).
o Third bag: ?L over ? hours.
o Fourth bag: ?L over ? hours.

Answer 5

1
1
1
2
kcl
1
2
1
4

Question 6

When glucose is mmol/L, add 10% ? at ?ml/hour.

o Adjust to keep blood glucose between ?-? mmol/L.

Answer 6

14
glucose
125
8-14

Question 7

Potassium;
o If plasma K under ?: add ?mmol KCI per litre NaCl.
o Consider after the ? litre of fluid has run through.
Clinically reassess the patient hourly for the first ?-? hours.
Regular laboratory monitoring of ?, ?, ? and
? is required.

Answer 7

5.4
40
first
hourly
4-6
glucose, ketones, pot, bicarb

Question 8

After recovery;
- Transfer to ? insulin once the patient is able to ? and ? normally, and venous pH is >?.
Stop the IV infusion ? hour(s) after the next ? injection of insulin.
Refer all patients to the ? team prior to discharge.

Answer 8

sc
eat
drink
7.3
1
sc
diabetes