Unit 5 & 6 Chapter 59 Diabetic Ketoacidosis and Hyperglycemic- Hyperosmolar State Flashcards
What is DKA
Complications of untreated hyperglycemia, metabolic acidosis , and increased ketones
What type of diabettes is the patient with DKA mainly affected by?
A. Type 1
B. Type 2
A. Type 1
-skinny
-
What is the cause of DKA
This condition results from the combination of insulin deficiency and an increase in hormone release that leads to increased liver and kidney glucose production.
occurs suddenly
S/s of DKA
- Blood sugar over 300
- Ketones in urine
- Dehydration
- Metabolic acidosis
- Polyuria
- Polyphagia
- Polydypsia
- Fruity odor breath
- Kussmal respirations; deep rapid breathes
- Vomiting,
- Abdominal pain,
- Weakness,
- Confusion,
- Shock,
- Coma.
- Weak thread pulse
- Dry mucous membranes
- Hyperthermia
- Increased urine specific gravity
Which of these definitions define kussmal respirations?
A. Deep rapid breaths
B. Shallow slow breathes
D. Deep slow breathes
D. Shallow rapid breathes
A. Deep rapid breaths
What is the typical fluid initiated for a patient with Diabetic Ketoacidosis?
A. 0.45% Normal Saline
B. 3% Sodium chloride
C. Lactated Ringers
D. 0.9% Normal Saline
D. 0.9% Normal Saline
What electrolyes fluid shift you expect to present for a patient with Diabetes Keto Acidosis?
A. Serum Sodium level 130
B. Serum Potassium level 6.0
C. Serum Magnesium level 2.4
D. Serum Calcium of 11.0
B. Serum Potassium level 6.0
HYPERKALEMIA
Mild-to-moderate hyperkalemia is common in patients with hyperglycemia. Insulin therapy, correction of acidosis, and volume expansion decrease serum potassium concentration.
How would hyperkalemia present its self on a ECG?
A. ST depression
B. Absent p wave
C. Peak T waves
D. ST inversion
C. Peak T waves
What fluid is given to prevent hypoglycemia to your patient who has gone through with blood glucose management?
A. 0.45% Normal Saline
B. 5% Dextrose in 0.45% NS
C. Lactated Ringers
D. 0.9% Normal Saline
B. 5% Dextrose in 0.45% NS
When blood glucose levels reach 250 mg/dL (13.8 mmol/L), give 5% dextrose in 0.45% saline. This solution helps prevent hypoglycemia and cerebral edema, which can occur when serum osmolarity declines too rapidly.
THERE SHOULD BE A STEADY DROP NOT A RAPID DROP IN BLOOD GLUCOSE THIS CAN CAUSE SERUM OSMARLITY TO SHIFT AND DECLINE RAPIDLY
What is the function of Serum Osmarlity?
Osmolality indicates the concentration of all the particles dissolved in body fluid.
When serum Osmarlity declines too rapidy, what are the typical signs and symptoms?
A. Hypernatremia
B. Hyperglycemia
C. Cerebral Edema
D. Weak thready Pulse
Cerebral Edema
-cerebral edema
-hypoglycemia
What is the normal range for Serum Osmarality?
285-295
Is IV Regular Insulin recommended for the tx of DKA
A. Yes
B. No
A.Yes
An initial IV bolus dose is given, followed by an IV continuous infusion. Continuous insulin infusion is used because insulin half-life is short and subcutaneous insulin has a delayed onset of action
What are indications that DKA is resolved?
A. Blood glucose 360
B. HCO3 23
C. PaO2 80%
D. SaO2 97%
B. HCO3 23
DKA is considered resolved when blood glucose is less than 200 mg/mL (11.2 mmol/L) along with a serum bicarbonate level higher than 18 mEq/L (mmol/L),venous pH is higher than 7.30**, and a calculated anion gap is less than 12 mEq/L (mmol/L).
After initiation of IV Insulin, what complication should you monitor for?
A. Dry warm skin
B. Serum Potassium Level 1.5
C. Serum Calcium 11.0
D. Constipation
B. Serum Potassium Level 1.5
Assess for signs of hypokalemia, including fatigue, malaise, confusion, muscle weakness, shallow respirations, abdominal distention or paralytic ileus, hypotension, and weak pulse.