Endocrine disorders: DKA

Question 1

Common clinical signs associated with diabetic ketoacidosis include?

Answer 1

PU/PD, lethargic, anorexic, inappetent, vomiting and weight loss

Question 2

Why might patients with DKA present with hyperkalemia?

Answer 2

Dehydration, decreased renal excretion, hypoinsulinemia, hyperglycemia, and acidemia

Question 3

Treatment for patients with DKA include -?

Answer 3

Fluid therapy (buffer included is ideal), hypokalemic patients should receive potassium supplementation (0.5 mEq/kg/hr), insulin (typically after 6hrs of fluid therapy alone)

Question 4

What is the initial dose of insulin for IM administration in DKA patients that are hyperglycemia?

Answer 4

0.2 U/kg initially, 0.1 U/kg hourly after

0. 05 U/kg/hr if Glu drops by more than 75 mg/dl/hr
1. 1 U/kg/hr if Glu drops by 50 - 75 mg/dl/hr
2. 2 U/kg/hr if Glu drops by less than 50 mg/dl/hr

Question 5

Initial treatment of DKA patients with a concurrent metabolic acidosis includes -?

Answer 5

Fluid therapy and insulin, bicarbonate is recommended when arterial pH drops below 7.0