DKA

Question 1

what is DKA?

Answer 1

-life-threatening complication of diabetes associated with ketosis, hyperglycemia & metabolic acidosis

-elevated glucose levels, decreased pH, decreased serum bicarb, elevated ketones, & dehydration

Question 1

who is DKA most common in?

Answer 1

T1DM

Question 2

precipitating factors of DKA

Answer 2

-illness
-stress
-trauma
-infection
-N/V
-new onset of T1DM

Question 3

typical BG levels with DKA

Answer 3

250-600

Question 4

DKA risk factors

Answer 4

-history of type 1 DM
-40+
-pregnancy
-condtions that cause extreme stress
-SES factors
-cocaine usage’-treatment plan non adherence

Question 5

DKA S/Sx

Answer 5

-acute onset usually under 24 hrs
-signs/sx related to hyperglycemia
-hypotension
-tachycardia
-signs of dehydration
-abdominal pain, nausea, vomiting
-fruity/acetone breath
-Kussmaul breathing
-mental status changes

Question 6

Diagnostic tests

Answer 6

-fingerstick BG
-ABG
-CBC with differential
-preg test
-BMP
-ketones
-betahydroxybutyrate

Question 7

betahydroxybutyrate

Answer 7

-trends with patient’s clinical status
-most predominate for ketone presence during DKA
->.5 indication of ketones
-treat at 3
-<.4 is normal

Question 8

other lab values

Answer 8

-normal to high potassium
-low serum osmolality
-high anion gap

Question 9

DKA treatment

Answer 9

-hydration, NS or LR (hypotonic is Na2+ is elevated)
-change to dextrose soln
-insulin drip (regular)
-potassium repletion
-continue treatment until anion gap is closed

Question 10

how much insulin in DKA?

Answer 10

0.1 units/kg/1hr

Question 11

how often are you checking BG during DKA treatment?

Answer 11

every 1 hour

Question 12

is potassium a vesicant?

Answer 12

yes, prefer centra line

also can slow down if hurts patient

Question 13

how often do you test for ketones?

Answer 13

every 2-3 hours