Jaber - DKA and HHS Flashcards
All of the following are signs of DKA except: A. Hypotension B. Dehydration C. Bradycardia D. Weight loss E. Impaired consciousness and/or coma
C. Bradycardia (should be tachycardia)
In DKA, serum ketones will be _____.
A. Positive
B. Negative
A. Positive
In DKA, urine ketones will be _____.
A. Positive
B. Negative
A. Positive
In DKA, the serum glucose will be > _____.
250
In the treatment of DKA, you give IV fluids and regular insulin. At what rate is the insulin given?
- 0.14 units/kg/hr as continuous infusion.
- If serum glucose doesn’t fall by 10% in first hour, give 0.14 unit/kg bolus, then continue previous infusion.
- when serum glucose reaches 200 mg/dL, reduce insulin infusion to 0.02-0.05 units/kg/hour or give rapid acting insulin at 0.1 units/kg SQ every 2 hours.
In the treatment of DKA, you give IV fluids and regular insulin. At what rate are fluids given?
Normal saline at 15-20 mL/kg/hour or 1-1.5 L/hour for first hour, then subsequent fluid replacement depends on patient specific factors.
For mild DKA, the anion gap will be > ____, while for moderate and severe DKA, the anion gap will be > ___.
Mild = >10
Moderate - severe = >12
What is the equation to calculate anion gap?
Anion gap = Na - (Cl + HCO3)
What is the equation for corrected serum Na?
Corrected Serum Na = Na + (1.6 (glucose - 100)/100)
In DKA, arterial pH will be less than or equal to ____.
7.3
When the pH is < ____, 100 mmol of bicarbonate must be given in 400 ml of water + 20 mEq KCl, infused for 2 hours and repeated every 2 hours until pH is greater than or equal to ____. Monitor K every __ hours.
6.9
7.0
Every 2 hours
In DKA, if potassium is < ____, hold insulin and give 20-30 mEq/hour of potassium until it is above that number.
3.3
In DKA, if potassium levels are between 3.3 and 5.2, what is the protocol?
Give 20-30 mEq K in each liter of IV fluids to keep serum potassium between 4-5 mEq/L.
In DKA, if K levels are > 5.2, what is the protocol?
Don’t give K, but check serum K levels every 2 hours.
In DKA, serum glucose should be kept between _____ and _____ until resolution of DKA.
150-200
Hyperosmolar hyperglycemic state (HHS) occurs in this patient population.
Type 2 diabetics and elderly patients with type 1 diabetes.
True or False: mortality rate is higher for HHS than DKA.
True
True or False: the management of DKA and HHS are similar.
True
DKA is more common in type ___ diabetics.
Type 1
True or False: the hyperglycemia seen with DKA is more severe than that seen with HHS.
False: hyperglycemia is usually more severe with HHS than DKA.
True or False: the Knesset of hyperglycemia is quicker in DKA than HHS.
True
Positive ketones in serum and urine are seen in: A. DKA B. HHS C. Both D. None of the above
A. DKA
True or False: Common symptoms of DKA include nausea, vomiting, and abdominal pain.
True
\_\_\_\_\_\_ is the most common cause of death in children and adolescents with type 1 diabetes. A. Heart disease B. DKA C. HHS D. None of the above
B. DKA
