Wk2 DKA

Question 1

Key features of DKA:

Answer 1

hyperglycemia

ketosis

acidosis

Question 2

Clinical presentation of DKA:

Answer 2

polyuria

polydypsia

polyphagia

weakness

Kussmaul’s respirations

N/V

hypotension –> Tachycardia

peripheral circulatory failure

Question 3

Lab criteria for DKA:

Answer 3

Gluc > 250

pH 12

stupor/coma

Question 4

5 key tx components for DKA:

Answer 4

Monitor

**FLUID resus

insulin/dextrose infusion (after gluc normalizes)

electrolyte repletion (watch for hyper K –> hypo K)

treat underlying cause

Question 5

Monitoring tests for DKA in the ER:

Answer 5

gluc, lytes w/anion gap, Mag

BUN/Cr + GFR

B-hydroxybutyrate + serum ketones

UA

CBC

EKG

Infx cultures, CXR

Cardiac enzymes

Question 6

Typical fluid deficit in DKA:

Answer 6

100 mL per kg

ex: 80 kg pt is down 8L !!!

Question 7

Initial fluid resus type:

Answer 7

NS

**switch to D5W/.45% NS once gluc below 250

Question 8

K in DKA:

Answer 8

hyper K at first

lower with insulin+gluc (watch out for hypo K)

**if lower than 3.3 initially, replace K first