DKA

Question 1

What are ELEVEN (11) S&S of DKA?

Answer 1

1. Polyuria
2. Polydipsia
3. Polyphasia
4. Weight loss
5. Vomiting
6. ABD pain
7. Dehydration
8. Weakness
9. Altered mental status
10. Shock
11. Coma

Question 2

What is the MOST COMMON precipitating FACTOR for developing DKA?

Answer 2

Infection

Question 3

DKA results from a combination of _____________ and _____________.

Answer 3

1. Insulin deficiency

2. ⬆️ counterregulatory hormone release

Question 4

What are FIVE (5) indicators that the patient consistently demonstrates EXPECTED OUTCOME of CONTROLLED BS?

Answer 4

1. Maintain BS within target range 🌡🎚
2. Adjust insulin doses to match eating patterns 🍽 and times of illness 🤒
3. Maintains easily digestible liquid diet containing carbs + salt 🥛
4. Describes correct procedure for urine ketone testing
5. Describes when to seek help 🚨 from health care provider 👩🏽‍⚕️

Question 5

The ONSET of DKA is __________.

Answer 5

Sudden

Question 6

Precipitating FACTORS of DKA include infection, stress and ____________.

Answer 6

Inadequate insulin dose

Question 7

What FIVE (5) things are PRIORITY ASSESSMENTS for DKA patient?

Answer 7

1. Airway 😗💨
2. LOC 🙇🏾‍♀️
3. Hydration 💧
4. Electrolytes
5. Blood Glucose Level 🌡

Question 8

True or False: skin turgor can be used to assess hydration status in older adults.

Answer 8

FALSE, d/t loss of elasticity and dryness from aging, skin turgor is an UNRELIABLE sign of dehydration in older adults.

Question 9

What are the TWO (2) main GOALS of FLUID THERAPY?

Answer 9

1. Restore volume

2. Maintain perfusion to the brain 🙇🏾‍♀️, heart ❤️ and kidneys

Question 10

What would be your (5) ASSESSMENT findings in a patient wit POOR KIDNEY FUNCTION and EXCESS FLUID volume?

Answer 10

1. Edema;
   Around the eyes 👀
   In the limbs 🖐🏾💪🏽👣
2. ABD girth
3. ⬆️ BP
4. Jugular Distention
5. Orthostatic hypostension

Question 11

What does ORTHOSTATIC HYPOTENSION INDICATE?

Answer 11

Volume depletion

Question 12

Typical IV INFUSION rates for the FIRST HOUR of FLUID THERAPY start at ____ to ____ mL/kg/hr.

Answer 12

15-20 mL/kg/hr

Question 13

HYPOTONIC fluids are generally INFUSED at what RATE following the initial fluid bolus?

Answer 13

4-14 mL/kg/hr

Question 14

When BLOOD GLUCOSE reaches 250 give __________________.

Answer 14

5% dextrose in 0.45% NS

Question 15

5% DEXTROSE in 0.45% NS prevents ________ and ________.

Answer 15

Cerebral Edema

Hypoglycemia

Question 16

During the first 24 hours of treatment the patient needs roughly ____ to ____ L of fluids to replace volume deficit and ongoing losses.

Answer 16

6-10 L

Question 17

During fluid replacement the nurse should monitor for ____________.

Answer 17

Fluid overload

Question 18

What is the GOAL of INSULIN THERAPY?

Answer 18

Lower serum glucose by about 50-75 mg/dL/hr

Question 19

What would be a CONTRADICTION of CONTINUOUS IV INSULIN infusion?

Answer 19

DKA is mild

Question 20

What are laboratory signs that the DKA has RESOLVED?

Answer 20

1. Blood glucose < 200
2. HCO3 < 18
3. pH > 7.3
4. Anion Gap < 12

Question 21

What is the NORMAL RANGE for ANION GAP?

Answer 21

7-9

Question 22

What are EIGHT (8) ASSESSMENT FINDINGS of HYPOKALEMIA?

Answer 22

1. Fatigue 😴
2. Malaise
3. Confusion
4. Muscle Weakness 💪🏽
5. Shallow Respirations
6. ABD Distention/ paralytic ileus
7. Hypotension
8. Weak Pulse

Question 23

What is a common CAUSE of DEATH with the TREATMENT of DKA?

Answer 23

Hypokalemia

Question 24

The nurse is educating a patient with DM proper blood glucose management and how to avoid DKA from occurring when ill. What will the nurse inform the pt to do when exhibiting symptoms of N/V, anorexia and blood glucose levels exceeding 250 mg/dL?

Answer 24

Check blood glucose levels every 4-6 hours.

Question 25

Patients must CHECK urine KETONES when blood glucose EXCEEDS ____.

Answer 25

300