CCS Flashcards
Quid of DKA criteria (4)
blood sugar level > 250 mg/dl
Bicarb < 15
Ketonemia
elevated anion gap
Could Amylase and lipase elevated in DKA
yes
Normal bicarb
24-30
How to control Anion Gap
Na- (Cl +Hco3)
normal anion Gap
10-14 meq
criteria for hyperosmolar state(5)
glucose more than 600 mg/dl serum osmolarity more than 330 absent or minimal ketonemia arterial PH above 7.3 serum bicarb above 20
Mechanism of fluid and electrolytes depletion in HS
osmotic diuresis
How to calculate serum osmolarity
2Na + glucose/18 + BUN/2.8
Normal serum osmolarity
275-295
normal arterial PH
7.35-7.45
corner stone of DKA treatment (3)
Hydration
Insulin
Potassium replacement
Hydration urgency phase in DKA (3)
1-2 liters in bolus
500 ML per hour during first 4 hours
continue with 250 ml for several hours
second phase of hydration in DKA if no signs of dehydration
continue with 1/2 NS 250-500 cc per hour for 3 to 4 hours
volume repletion in DKA
4 to 10 liters
What to do in DKA when glycemia is < ou egal a 250
DW 5 or 10%