DKA (Diabetic Ketoacidosis)

Question 1

What is DKA?

Answer 1

Life threatening complication of T1DM
- no insulin in the body so fats start breaking down ketones
- leads to hyperglycaemia, ketosis + acidosis

Question 2

What happens to glucose in the body during DKA

Answer 2

• glucose is not being used as there is no insulin to take the glucose into the cell so it remains in the blood (hyperglycaemia)

Question 3

What are ketones ?

Answer 3

A byproduct of fat breakdown (acidic- metabolic acidosis)

Question 4

What are the causes of DKA?

Answer 4

• undetected diabetes
• when the body needs more insulin than norm : illness, stress
• certain meds : corticosteroids/thiazides
• not eating/skipping meals : body goes into starvation mode- starts burning ketones
• not taking insulin as scheduled - poor glycemic control

Question 5

What are the S&S of DKA ?

Answer 5

-polyuria
-polydipsia
-dehydration
-nausea, vomiting, abdo pain
-kussmal breathing (rapid deep breathing as side effect of metabolic acidosis)
- acetone (fruity) smell of breath (bcs of breakdown of ketones)
- ketones present in urine
- tachycardia
- hypotension
- confusion
- fatigue

Question 6

What are the nursing intervention for DKA ?

Answer 6

• teach pt how to prevent this and the warning signs :
  
  • monitor glucose + ketones in urine when sick
  • if cannot eat/drink at all to notify doctor 4 further treatment
  • if can drink- every hr
  • if bs > 16.7mmol/l consistently, notify doc
  • notify doc if exp : 3 P’s, abdo pain, fruity breath, N+V

Question 7

What is the pharmacological goal when treating a patient with DKA?

Answer 7

-hydrate
- reduce bs lvl
- monitor K+ lvl + pt for cerebral oedema
- correct acid-base imbalance