DKA

Question 1

what is DKA?

Answer 1

in DKA, cells cannot convert glucose for energy so instead the body will start using fat for energy. The byproduct of fat are ketones and these strong acids can lead to metabolic acidosis

Question 2

who are at risk for DKA?

Answer 2

only occurs in type 1 diabetes because the body is not producing any insulin at all

Question 3

what are clinical manifestations of DKA?

Answer 3

1. rapid onset of 48-72 hours
2. polyuria/polydipsia/polyphagia
3. fruity breath
4. hyperglycemia >300
5. kussmaul respirations

Question 4

what are priority nursing interventions for DKA?

Answer 4

1. always ABCs
2. give rapid NS fluid replacement with regular IV insulin bolus together–> then give continuous IV insulin infusion
3. add glucose to fluid when levels near 250
4. monitor glucose levels every hour
5. monitor potassium levels for hypokalemia

Question 5

when can the DKA patient be given SQ insulin?

Answer 5

when glucose < 200 and when ketones are gone, the patient is more stabilized and place them on a sliding scale with SQ insulin

Question 6

how can the nurse monitor potassium levels with a DKA patient?

Answer 6

put them on continuous cardiac monitoring

Question 7

what are lab findings for DKA?

Answer 7

1. check ABGs which should indicate metabolic acidosis
2. high osmolarity because blood is concentrated due to glucose
3. ketones present in urine and blood
4. BUN and CRT will be high

Question 8

what are complications of DKA?

Answer 8

1. hypokalemia due to insulin therapy after initial hyperkalemia
2. severe dehydration–> give NS
3. prolong metabolic acidosis can lead to a coma
4. high osmolarity levels can cause neurovascular changes