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Diabetic Ketoacidosis Treatment Guidelines

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DKA diabetic ketoacidosis nursing management pathophysiology & treatment. DKA is a complication of diabetes mellitus and mainly affects type 1 diabetics. DKA management includes controlling hyperglycemia, ketosis, and acdidosis. Signs & Symptoms include polyuria, polydipsia, hyperglycemia greater than 300 mg/dL, Kussmaul breathing, acetone breath, and ketones in the urine. Typically DKA treatment includes: intravenous fluids, insulin therapy (IV regular insulin), and electrolyte replacement. This video details what the nurse needs to know for the NCLEX exam about diabetic ketoacidosis. I also touch on DKA vs HHS (diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome (please see the other video for more details). Quiz on DKA: http://www.registerednursern.com/diab... Lecture Notes for this video: http://www.registerednursern.com/diab... Diabetes NCLEX Review Videos: https://www.youtube.com/playlist?list... Subscribe: http://www.youtube.com/subscription_c... Nursing School Supplies: http://www.registerednursern.com/the-... Nursing Job Search: http://www.registerednursern.com/nurs... Visit our website RegisteredNurseRN.com for free quizzes, nursing care plans, salary information, job search, and much more: http://www.registerednursern.com Check out other Videos: https://www.youtube.com/user/Register... Popular Playlists: "NCLEX Study Strategies": https://www.youtube.com/playlist?list... "Fluid & Electrolytes Made So Easy": https://www.youtube.com/playlist?list... "Nursing Skills Videos": https://www.youtube.com/playlist?list... "Nursing School Study Tips": https://www.youtube.com/playlist?list... "Nursing School Tips & Questions": https://www.youtube.com/playlist?list... "Teaching Tutorials": https://www.youtube.com/playlist?list... "Types of Nursing Specialties": https://www.youtube.com/playlist?list... "Healthcare Salary Information": https://www.youtube.com/playlist?list... "New Nurse Tips": https://www.youtube.com/playlist?list... "Nursing Career Help": https://www.youtube.com/playlist?list... "EKG Teaching Tutorials": https://www.youtube.com/playlist?list... "Personality Types": https://www.youtube.com/playlist?list... "Dosage & Calculations for Nurses": https://www.youtube.com/playlist?list... "Diabetes Health Managment": https://www.youtube.com/playlist?list...

Management Of Diabetic Ketoacidosis (dka)

Management of Acute Diabetic Ketoacidosis (DKA) Below is the link to the care pathway for the management of diabetic ketoacidosis in adults. Specific guidelines exist for the management of DKA in children. In patients aged 13-16 years presenting with DKA, the management of DKA should be discussed with relevant paediatric staff. Diagnosis Severe uncontrolled diabetes with: Hyperglycaemia (blood glucose >14mmol/L, usually but not exclusively) Metabolic acidosis (H+ >45mEq/L or HCO3- <18mmol/L or pH <7.3 on venous gases) Ketonaemia (>3mmol/L) / ketonuria (>++) Severity criteria One or more of the following may indicate severe DKA and should be considered for level 2 care (MHDU if available). It may also be necessary to consider a surgical cause for the deterioration. Blood ketones >6mmol/L Bicarbonate level <5mmol/L Venous / artierial pH <7.1 Hypokalaemia on admission (<3.5mmol/L) GCS <12 or abnormal AVPU scale Oxygen saturation <92% on air (assuming normal baseline respiratory function) Systolic BP <90mmHg, pulse >100bpm or <60bpm Anion gap >16 [anion gap = (Na+ + K+) – (Cl- + HCO3-)] Cerebral oedema The care pathways for the emergency management of DKA should be used for all eligi Continue reading >>

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  1. Migdalia

    Source(s): Destroy Diabetes Starting Today : http://DiabetesCure.raiwi.com/?BlIF

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    Source(s): I Cured My Diabetes : http://DiabetesGoFar.com/?YLpB

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    The normal blood glucose levels for teenagers are the same as they are for adults. A blood glucose level of 190 is quite high. A single donut will not raise your blood glucose that high. Nor will sweetened tea. Check your blood glucose regularly for a while. If it gets really high after eating (above 140-150 or so), or if it's above 110 or so while you are fasting (no food in six hours or so), you should see a doctor to find out if you have diabetes. If it is normal most of the type but spikes significantly after eating, you need to keep an eye on it—ask your doctor for recommendations on how best to monitor it, just in case. If it's normal all the time while you are fasting, with only a modest increase after a meal, you're fine. Infections can raise blood glucose temporarily. However, you should still check again after you've recovered, just to make sure that no problem is developing.
    For the best answers, search on this site https://smarturl.im/aDJhG

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My Site - Chapter 15: Hyperglycemic Emergencies In Adults

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) should be suspected in ill patients with diabetes. If either DKA or HHS is diagnosed, precipitating factors must be sought and treated. DKA and HHS are medical emergencies that require treatment and monitoring for multiple metabolic abnormalities and vigilance for complications. A normal blood glucose does not rule out DKA in pregnancy. Ketoacidosis requires insulin administration (0.1 U/kg/h) for resolution; bicarbonate therapy should be considered only for extreme acidosis (pH7.0). Note to readers: Although the diagnosis and treatment of diabetic ketoacidosis (DKA) in adults and in children share general principles, there are significant differences in their application, largely related to the increased risk of life-threatening cerebral edema with DKA in children and adolescents. The specific issues related to treatment of DKA in children and adolescents are addressed in the Type 1 Diabetes in Children and Adolescents chapter, p. S153. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are diabetes emergencies with overlapping features. With insulin deficiency, hyperglycemia causes urinary Continue reading >>

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  1. Laura

    I have CMT1 will this affect nerve damage worse?

  2. Annie

    I Have Top Of Fiot Tendonitis. Will My New Revitive Medic? Help

  3. mags

    I had a fratured tibia and fibia 6 month ago. Had surgery where pins were inserted. Also had skin graft to shin area where bone protruded. Can I use revitive?

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Get clarity on DKA (diabetic ketoacidosis) with memorable illustrations from Dr. Seheult. See the DKA series free at http://www.medcram.com. This video is part of the "MedCram Remastered" series: A video we've re-edited & sped up to make learning even more efficient. This is video 1 of 2 on diabetic ketoacidosis (pathophysiology and signs of diabetic ketoacidosis / DKA): 0:08 DKA stats 0:47 DKA - cellular anatomy 1:00 mitochondria 1:48 beta-oxidation 2:30 insulin function 3:08 pyruvate 3:19 diabetes mellitus type 1 3:26 diabetes mellitus type 2 4:48 ketone bodies (acetone, acetoacetate, b-hydroxybutyrate) 6:09 carboxylic acid 6:23 conjugate base (anion gap acidosis) 7:38 beta-oxidation 8:17 DKA review 8:57 diabetic ketoacidosis - hyperkalemia 9:37 diabetic ketoacidosis - dehydration 9:50 osmotic diuresis 10:10 dehydration 10:27 diabetic ketoacidosis - potassium effects 11:04 diabetic ketoacidosis - Cr elevation / renal failure 11:30 anion gap metabolic acidosis 12:09 measuring ketone bodies (serum ketones, b-hydroxybutyrate) Visit https://www.MedCram.com for part 2 of this course (on DKA treatment) and over 100 lectures. This is the home for ALL MedCram.com medical videos (many medical videos, medical lectures, and quizzes are not on YouTube). Speaker: Roger Seheult, MD Co-Founder of MedCram.com (https://www.medcram.com) Clinical and Exam Preparation Instructor Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine. Visit https://www.MedCram.com for hundreds of clear & concise videos MedCram = MORE understanding in LESS time MedCram: Medical education topics explained clearly including: Respiratory lectures such as Asthma and COPD. Renal lectures on Acute Renal Failure and Adrenal Gland. Internal medicine videos on Oxygen Hemoglobin Dissociation Curve and Medical Acid Base. A growing library on critical care topics such as Shock, Diabetic Ketoacidosis (DKA), and Mechanical Ventilation. Cardiology videos on Hypertension, ECG / EKG Interpretation, and heart failure. VQ Mismatch and Hyponatremia lectures have been popular among medical students and physicians. The Pulmonary Function Tests (PFTs) videos and Ventilator-associated pneumonia bundles and lectures have been particularly popular with RTs. NPs and PAs have given great feedback on Pneumonia Treatment and Liver Function Tests among many others. Dr. Jacquet teaches our FAST exam tutorial & bedside ultrasound courses. Many nursing students have found the Asthma and shock lectures very helpful. We're starting a new course series on clinical ultrasound/ultrasound medical imaging. Recommended Audience - Medical professionals and medical students: including physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, EMT and paramedics, and many others. Review and test prep for USMLE, MCAT, PANCE, NCLEX, NAPLEX, NBDE, RN, RT, MD, DO, PA, NP school and board examinations. More from MedCram.com medical lectures: Facebook: https://www.facebook.com/MedCram Google+: https://plus.google.com/u/1/+Medcram Twitter: https://twitter.com/MedCramVideos Subscribe to the official MedCram.com YouTube Channel: https://www.youtube.com/subscription_... Produced by Kyle Allred PA-C Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical education and exam preparation purposes, and not intended to replace recommendations by your doctor or health care provider.

Diabetic Ketoacidosis (dka): Treatment Guidelines

Diabetic ketoacidosis (DKA), resulting from severe insulin deficiency, accounts for most hospitalization and is the most common cause of death, mostly due to cerebral edema, in pediatric diabetes. This article provides guidelines on management to restore perfusion, stop ongoing ketogenesis, correct electrolyte losses, and avoid hypokalemia and hypoglycemia and the circumstances that may contribute, in some instances, to cerebral edema (overhydration, rapid osmolar shifts, hypoxia). These guidelines emphasize the importance of monitoring glycemia, electrolytes, hydration, vital signs, and neurologic status in a setting where response can be rapid if necessary (e.g., mannitol for cerebral edema). Most important is the prevention of DKA in established patients by close supervision of those most likely to omit insulin, or during illness, and a high index of suspicion for diabetes to prevent deterioration to DKA in new patients, particularly those under age 5, who are at greatest risk of complications. Continue reading >>

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  1. MissyMousums

    Hello all!
    Yesterday I received two shots of cortisone due to bursitis in both hips (I am allergic to aspirin and NSAIDs). I have had shots in the past but only one at a time. I was told by the doctor that it may affect my blood sugar and boy has it! Anytime I eat something, it shoots up to around 300. I have stayed away from carbs and caffeine so I can't figure this out. Tonight, in an hour's time went from 148 to 257. Now it is slowly decreasing. It seems that eating is making it worse and I don't know what to do. I called the advice nurse (Veterans hospital) and she said that the first 24 hours it will be like this. It's been over 24 hours and I feel horrible and my skin feels very warm (this my be due to just the cortisone shot itself. On top of all this, I cannot take my BP med because it's a diuretic so my BP is up to 170/108. What can I do?? I appreciate any help one can give!

    Post Edited (MissyMousums) : 7/20/2008 4:14:52 AM (GMT-6)
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  2. Lanie G

    Welcome to the Forum Missy, since cortisone is a steroid your blood sugar will definitely be higher while it's in your system. How much it affects it depends on the severity of diabetes so it varies from patient to patient, which is why people on medication have to test and adjust their meds for this rise. I understand that the cortisone levels will decrease slowly (and you had two shots so it would be longer than if you'd had one obviously) but you need to keep testing until it goes down to the levels the blood sugar was before. I don't know why you can't take your BP medicine. Did the doctor tell you not to? Be sure you talk to the doctor/nurse.

    Lanie
    forum moderator - diabetes
    diabetes controlled so far by low/no carb diet and exercise; no meds

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  3. MissyMousums

    Hi Lanie!
    I was told to hold off on the diuretic (water pill) because it could make the whole thing worse. I guess they figure I would be ok to go without for a day or so. Normally without meds my BP is around 150/98 but my BP may be higher because I just don't feel well and I am a little stressed with this whole thing. My blood sugars today are normal but all I have eaten was eggs. I am really pushing the fluids so that may be helping. I am afraid to eat anything with carbs because yesterday my blood sugar skyrocketed after eating a piece of toast. The advice nurse with the VA said if it gets too high (above 400), I should go to the ER for insulin. I have only been a diagnosed diabetic for a year so this whole thing is new to me. I started going to the VA for this because my now former family doctor had me on meds and she kept diagnosing me as pre-diabetic which excluded me from getting help with the cost of test strips or getting a referral to an endocrinologist.
    I will contact the nurse again if things get bad but I think hearing from fellow diabetics who may have been through this would help also and it has! Thanks for responding!
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