Dka Treatment Protocol

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1. Initiate Iv Fluids Stat: Ivf Should Be Started In The Ed And Continued In Icu As Needed

· Estimate intravascular volume status (via BUN/Cr, VS, orthostatic BP, urine output, physical exam, HgB)(to estimate saline requirement. · Assess free water deficit using corrected serum Na. A. Initial Fluid Orders: I. First correct intravascular fluid volume deficit with normal saline at a rate dependant on severity (being more cautious if cardiac or renal disease) a) 0.9% NaCl at 1-3 Liters /hr (15-20ml/kg) over 1 hour b) Give additional 0.9% NaCl IV rapidly if patient remains volume depleted. B. While Blood Glucose greater than 250 mg/dL -- Subsequent Fluid Orders: I. Calculate corrected Na: a) Corrected Sodium less than 134 mEq/L: continue 0.9% NaCl IV at 250-500 ml/hr until glucose less than 250 mg/dL, or corrected Na greater than 134 mEq/L. b) Corrected Sodium greater than or equal to 134 mEq/L: continue with 0.45% NaCl IV at 250-500 ml/hour until glucose less than 250 mg/dL, or corrected Na less than 134 mEq/L. II. If corrected Na decreases more than 2 mEq per hour, consider slowing the infusion rate. C. WHEN Blood Glucose less than 250mg/dL -- Subsequent Fluid Orders: I. Calculate corrected Na: a) Corrected sodium less than134 mEq/L: D5W/0.9% NaCl IV at 100 - 200 ml/ Continue reading >>

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Popular Questions

  1. anbeav

    Most animals don't have a mechanism for ketosis. Ketosis is a mechanism to provide energy for the brain. Animal brains do not require as much energy as humans and thus the energy requirements can be fulfilled via gluconeogenesis.

  2. anbeav

    My cat is on a keto diet (raw food carnivore diet) but ketones are always negative. Here's one of many articles I've read it in http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194504/. I've also talked to my vet about this.
    Cats are not humans. Humans have mechanisms for ketosis why are you assuming all animals do and in response to the same stimuli? Anyone can, yes. Not any animal. That's a big difference.
    Ketosis is ketosis. Even on a protein and fat only diet my cat is not in ketosis. His walnut sized brain doesn't demand it. Cats do get ketostix when diabetic but not just from eating a natural cat diet. I don't like it misrepresented either which is why I don't discuss things when drunk :)

  3. anbeav

    If you switched the cats diet it wouldn't go into ketosis though. I'm speaking of nutritional ketosis not ketoacidosis. Other animals don't achieve nutritional ketosis but can achieve ketoacidosis, not the same thing.
    And what do you mean that humans should never be in ketosis for extended periods of time? Why?
    You're mixing terms-ketosis and ketoacidosis

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