[Exam 4] Show me for DKA / HHS Flashcards
DKA: What is this?
Occurs in Type 1 Diabetics
DKA: What are some causes of this?
Trying to ration / missed insulin
Illness/Infection
Undiagnosed Diabetic
DKA: What is going on to insulin?
Decreased Insulin
DKA: What changes occur in the body because of this?
Elevated blood sugar levels (300-800)
Cells breakdown fatty acids -> leading to acidosis
DKA: When glucose levels get high, what do kidneys do?
Try to filter out glucose, causing increased urination and osmotic diuresis
DKA: If urine was tested it would be positive for what
Glucose
DKA: Whaht signs may a person show with this?
Polyuria, Polydipsia
DKA: With kidneys dumping all the fluid, this can lead to what changes in the body?
Increased creatinine and BUN
Potassium may flucate as well.
DKA: What happens when cells start breaking down fatty acids?
Ketones develop through ketogenesis leading to acetone being formed
DKA: What does acetone do?
This formed the fruity breath that is a hallmark sign of these patients.
DKA: How will the ABGs be for this patient?
Will be acidotic.
pH < 7.35 and HCO3 < 22.
DKA: What happens to hydrogen ions?
Will go into cell, while kicking potassium out of the cells. This is what causes hyperkalemia in blood.
HHS: What type of diabetic has this
Type 2
HHS: What usually initated this?
When they are sick, causing an increase in insulin demand and then causing glucose levels to increase
HHS: How does this progress
Over a couple of days . DKA can be sudden
HHS: What happens to insulin and glucose levels?
Decreased insulin and increased blood glucose levels (600 - 1200)
HHS: What happens to fluid in body?
Osmotic diuresis occurs, causing all of the fluid to be expelled.
Will have dehydration
HHS: What changes in labs will kidneys cause?
Increase in creatinine and BUN
HHS: What doesn’t happen here that happens in DKA?
The patient does not go into acidosis. Because there is still insulin in the body and glucose is binding to these cells. Their channels are still being opened allowing body to get energy
No ketogensis because of this.
Management of DKA/HHS: What will normally be started first?
Fluids. Such as 1L of NS over a couple of hours and then 1/2 NS until the blood sugar reaches 300.
Management of DKA/HHS: What happens once blood sugar reaches 300?
It will get swtiched to D5W because you do not want ot bottom out glucose levels
Management of DKA/HHS: What treatment occurs after fluids?
Insulin drip.
Management of DKA/HHS: Why is an insulin drip used??
Allows m ore insulin to be available to bring glucose levels down
Management of DKA/HHS: What role does insulin specificaly have with DKA?
In DKA, it will correct the acidosis because glucose is being pushed into cells and body does not need to rely on fatty acids for energy.
Management of DKA/HHS: What is done once acidosis is corected?
We have to replace potassium because it is no longer being pushed out of the blood
Management of DKA/HHS: DKA should be associated with what
Type 1 DM, in metabolic acidosis
Management of DKA/HHS: Big signs of DKA?
Polyuria , Polydipsia, Dehydrated, Fatigued, Hypotension , Fruity Breath (Ketones)
Kussmal Respiration (because lungs are trying to blow off excess acid)
Management of DKA/HHS: How is DKA treated?
With fluids, insulin, and replacing electrolytes
Management of DKA/HHS: HHS should be associated with what?
DM2 precipated by some sort of illness with a slow illness
Management of DKA/HHS: Big signs of HHS?
Dehydrated so decreased blood pressure. Blood sugar 600-1200. AMS.
Management of DKA/HHS: Big management for HHS?
Fluids, electrolytes, and insulin.
