Exam 1: DKA Flashcards
list the top four things we do when assessing a patient for DKA?
- blood glucose
- ask - do you know where you are?
- check VS
- obtain labs
what is the lab value for hypoglycemia
less than 70 mg/dL
what is the lab value for hyperglycemia?
greater than 200 mg/dL
what is the first nursing intervention when a patient is in DKA? why?
give 0.9 NS; replenish fluids and electrolytes lost
the blood is so thick from all of the sugar that it is hard for it to perfuse. giving NS will help to rehydrate the patient, thinning the blood, allowing for increased perfusion.
what is the second intervention when a patient is in DKA?
IV insulin (REGULAR)
describe the K+ level in a patient with DKA
HIGH potassium level
what do we need to monitor in patients with high K+?
cardiac function
how do we monitor cardiac function?
24/7 telemetry
EKG
how often do we check K+ levels?
Q4 hours
how often do we check glucose levels? can this be delegated?
Q1 hours; yes - delegate to UAP
at what glucose level do we change IV fluids?
when glucose is below 250
we switch from what IV fluids to what when glucose is below 250?
0.9 NS to dextrose (D5 0.45)
why do we give D5 0.45 to DKA patients?
to reduce the rate at which the blood glucose is reduced
what happens if we bring the glucose level down too quickly?
cerebral edema
what do we give any time a patient has edema?
diuretics
what diuretic is given for cerebral edema?
mannitol
do we want to give fluids at a high or low rate? why?
HIGH; compensate for fluid loss
what are the 3 P’s of DKA?
polyuria (excessive urine)
polydipsia (excessive thirst)
polyphagia (excessive hunger)
what is a classic sign of DKA?
Kussmaul respirations
what is given IVPfor extreme hypoglycemia?
D50 (25-50 mL)
how do we give D50?
IV push
why is apple juice preferred over OJ for hypoglycemia?
OJ is high in K+
How is glucagon administered?
subQ or IM (1 mg)
who can start a patient on an insulin drip?
RN only
