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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...

Small Animal - Diabetic Ketoacidosis (dka)

Normal healthy animal in starvation pathophysiology Pancreatic alpha cells secrete progressively more glucagon -> promotes hepatic gluconeogenesis and triggers release of stored energy from fat (lipolysis) -> free fatty acids and glycerol released from stored triglycerides -> glycerol to glucose and fatty acids are converted to ketones by the liver Ketones can be used for energy in the Kreb's cycle Basal insulin secretion ensures that energy is released at an appropriate rate by limiting glucagon secretion and limiting lipolysis what is the simplest and effective way to give and regulate a DKA pt's insulin administration? IV regular insulin Dogs: 0.1 U/kg/hr Cats: 0.05-0.1 U/kg/hr -draw up total daily dose, add to 250-ml bag 0.9% NaCl -start every single pt at 10 mls/hr and adjust based on 2 hr glucose measurements -switch fluids to one w/ dextrose when BG <250 mg/dl Continue reading >>

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  1. Asystole RN

    yes! very astute observation.
    to understand the relationship one must understand hyperglycemia. first answer the question, what pathophysiology occurs with hyperglycemia? there are key s&s the nurse is looking for when attempting to assess for hyperglycemia, there lays a clue to the connection.
    then answer, what can cause the blood urea nitrogen level to be elevated?
    hint.
    "what is hyperglycemia?
    hyperglycemia (hi"per-gli-se'me-ah) is an increase in plasma glucose (blood sugar). it can turn into a complex medical condition -- diabetic ketoacidosis (ke"to-as"id-o'sis) and coma -- if it's not treated on time and adequately. hyperglycemia is usually the first sign of diabetes mellitus. symptoms of hyperglycemia are
    polyuria (pol"e-yur'e-ah) (excess urine)
    polydipsia (pol"e-dip'se-ah) (thirst)

    polyphagia (pol"e-fa'je-ah) (excessive hunger) "
    the american heart association, (2011). hyperglycemia and hypoglycemia. retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4593

  2. illuminati88

    Hi,
    Look into what physiological processes occur in hyperglycemia, what the body resorts to when glucose is not available for energy, and by products of amino acid breakdown. That should help you on the path

  3. ladyangel341

    Since we know why blood glucose elevated lets go to BUN...
    There are 3 reasons of elevation of the BUN
    1) renal impairment
    2) pregnancy
    3) excessive breakdown of protein (called catabolism)
    On that three the closest relation to increase glucose is the breakdown of protein...
    Why there's a breakdown of protein if there is an increase number of blood glucose?
    We are talking about diabetic patient which there is a decrease production of insulin. Insulin helps absorption of glucose into the cells. Lack of insulin makes the glucose remain in the blood stream and some excreted through urination.
    So what will the body use for energy if there is no glucose?
    That's where protein or fat breakdown happens. The proteins breakdown makes the BUN elevated which urea is the byproduct of protein breakdown.
    Hope I helped^^:heartbeat

  4. -> Continue reading
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Hyperglycemic crises: Hyperglycemic hyperosmolar nonketotic coma (HHNK) versus DKA. See DKA video here: https://youtu.be/r2tXTjb7EqU This video and similar images/videos are available for instant download licensing here https://www.alilamedicalmedia.com/-/g... Voice by: Penelope Hammet Alila Medical Media. All rights reserved. All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Support us on Patreon and get FREE downloads and other great rewards: patreon.com/AlilaMedicalMedia Hyperosmolar hyperglycemic state, or HHS, is another ACUTE and life-threatening complication of diabetes mellitus. It develops slower than DKA, typically in the course of several days, but has a much higher mortality rate. Like DKA, HHS is triggered when diabetic patients suffer from ADDITIONAL physiologic stress such as infections, other illness, INadequate diabetic treatment or certain drugs. Similar to DKA, the RISE in COUNTER-regulatory hormones is the major culprit. These hormones stimulate FURTHER production and release of glucose into the blood, causing it to overflow into urine, resulting in excessive LOSS of water and electrolytes. The major DIFFERENCE between HHS and DKA is the ABSENCE of acidosis in HHS. This is because, unlike DKA, the level of insulin in HHS patients is HIGH enough to SUPPRESS lipolysis and hence ketogenesis. This explains why HHS occurs more often in type 2 diabetics, who have more or less normal level of circulating insulin. Reminder: type 2 diabetics DO produce insulin but their cells do NOT respond to insulin and therefore cannot use glucose. Because symptoms of acidosis are NOT present, development of HHS may go UNnoticed until blood glucose levels become EXTREMELY high. Severe dehydration results in INcreased concentrations of solutes in the blood, raising its osmolarity. HyPERosmotic blood plasma drives water OUT of bodys tissues causing cellular dysfunction. Primary symptom of HHS is ALTERED consciousness due to excessive dehydration of brain tissues. This can range from confusion to coma. Emergency treatment consists of intravenous fluid, insulin and potassium similar to those used in DKA.

Diagnosis And Treatment Of Diabetic Ketoacidosis And The Hyperglycemic Hyperosmolar State

Go to: Pathogenesis In both DKA and HHS, the underlying metabolic abnormality results from the combination of absolute or relative insulin deficiency and increased amounts of counterregulatory hormones. Glucose and lipid metabolism When insulin is deficient, the elevated levels of glucagon, catecholamines and cortisol will stimulate hepatic glucose production through increased glycogenolysis and enhanced gluconeogenesis4 (Fig. 1). Hypercortisolemia will result in increased proteolysis, thus providing amino acid precursors for gluconeogenesis. Low insulin and high catecholamine concentrations will reduce glucose uptake by peripheral tissues. The combination of elevated hepatic glucose production and decreased peripheral glucose use is the main pathogenic disturbance responsible for hyperglycemia in DKA and HHS. The hyperglycemia will lead to glycosuria, osmotic diuresis and dehydration. This will be associated with decreased kidney perfusion, particularly in HHS, that will result in decreased glucose clearance by the kidney and thus further exacerbation of the hyperglycemia. In DKA, the low insulin levels combined with increased levels of catecholamines, cortisol and growth hormone Continue reading >>

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Popular Questions

  1. Asystole RN

    yes! very astute observation.
    to understand the relationship one must understand hyperglycemia. first answer the question, what pathophysiology occurs with hyperglycemia? there are key s&s the nurse is looking for when attempting to assess for hyperglycemia, there lays a clue to the connection.
    then answer, what can cause the blood urea nitrogen level to be elevated?
    hint.
    "what is hyperglycemia?
    hyperglycemia (hi"per-gli-se'me-ah) is an increase in plasma glucose (blood sugar). it can turn into a complex medical condition -- diabetic ketoacidosis (ke"to-as"id-o'sis) and coma -- if it's not treated on time and adequately. hyperglycemia is usually the first sign of diabetes mellitus. symptoms of hyperglycemia are
    polyuria (pol"e-yur'e-ah) (excess urine)
    polydipsia (pol"e-dip'se-ah) (thirst)

    polyphagia (pol"e-fa'je-ah) (excessive hunger) "
    the american heart association, (2011). hyperglycemia and hypoglycemia. retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4593

  2. illuminati88

    Hi,
    Look into what physiological processes occur in hyperglycemia, what the body resorts to when glucose is not available for energy, and by products of amino acid breakdown. That should help you on the path

  3. ladyangel341

    Since we know why blood glucose elevated lets go to BUN...
    There are 3 reasons of elevation of the BUN
    1) renal impairment
    2) pregnancy
    3) excessive breakdown of protein (called catabolism)
    On that three the closest relation to increase glucose is the breakdown of protein...
    Why there's a breakdown of protein if there is an increase number of blood glucose?
    We are talking about diabetic patient which there is a decrease production of insulin. Insulin helps absorption of glucose into the cells. Lack of insulin makes the glucose remain in the blood stream and some excreted through urination.
    So what will the body use for energy if there is no glucose?
    That's where protein or fat breakdown happens. The proteins breakdown makes the BUN elevated which urea is the byproduct of protein breakdown.
    Hope I helped^^:heartbeat

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This video relates abdominal pain according to different abdominal regions and states the most important differential diagnosis of each pain position.

Exam Shows Diffuse Abdominal Tenderness With Guarding.

A 14 y/o female is brought to the emergency department by her mother after being found unresponsive at home. She had been ill the day before with nausea and vomiting, but was not running a fever. Her parents had kept her home from school that day. When her mother came home at lunchtime to check on her, she was very lethargic and not responding coherently. By the time she arrived at the hospital, she had to be brought in to the ED on a gurney. Initial evaluation showed O2 sat 100% on room air, pulse 126, respirations 30, BP 92/68, temperature 101.2 F. She appears pale, mucous membranes are dry and she only responds to painful stimuli. Exam shows diffuse abdominal tenderness with guarding. Differential diagnosis? What initial treatment would you suggest? What labs would you order? Any xrays or additional studies? CBC WBC 23,500 Hgb 14.2 g/dL Hct 45% Platelets 425,000 BMP Sodium 126 Potassium 5.2 Chloride 87 CO2 <5 BUN 32 Creatinine 1.5 Glucose 1,376 Arterial Blood Gases pH 7.19 Po2 100 mm Hg HCO3 7.5 mmo/L Pco2 20 mm Hg Sao2 98% (room air) Urine Specific gravity 1.015 Ketones 4+ Leukocytes few Glucose 4+ Nitrates 0 RBCs many Diabetic ketoacidosis (DKA) is an acute metabolic complicat Continue reading >>

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Popular Questions

  1. Asystole RN

    yes! very astute observation.
    to understand the relationship one must understand hyperglycemia. first answer the question, what pathophysiology occurs with hyperglycemia? there are key s&s the nurse is looking for when attempting to assess for hyperglycemia, there lays a clue to the connection.
    then answer, what can cause the blood urea nitrogen level to be elevated?
    hint.
    "what is hyperglycemia?
    hyperglycemia (hi"per-gli-se'me-ah) is an increase in plasma glucose (blood sugar). it can turn into a complex medical condition -- diabetic ketoacidosis (ke"to-as"id-o'sis) and coma -- if it's not treated on time and adequately. hyperglycemia is usually the first sign of diabetes mellitus. symptoms of hyperglycemia are
    polyuria (pol"e-yur'e-ah) (excess urine)
    polydipsia (pol"e-dip'se-ah) (thirst)

    polyphagia (pol"e-fa'je-ah) (excessive hunger) "
    the american heart association, (2011). hyperglycemia and hypoglycemia. retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4593

  2. illuminati88

    Hi,
    Look into what physiological processes occur in hyperglycemia, what the body resorts to when glucose is not available for energy, and by products of amino acid breakdown. That should help you on the path

  3. ladyangel341

    Since we know why blood glucose elevated lets go to BUN...
    There are 3 reasons of elevation of the BUN
    1) renal impairment
    2) pregnancy
    3) excessive breakdown of protein (called catabolism)
    On that three the closest relation to increase glucose is the breakdown of protein...
    Why there's a breakdown of protein if there is an increase number of blood glucose?
    We are talking about diabetic patient which there is a decrease production of insulin. Insulin helps absorption of glucose into the cells. Lack of insulin makes the glucose remain in the blood stream and some excreted through urination.
    So what will the body use for energy if there is no glucose?
    That's where protein or fat breakdown happens. The proteins breakdown makes the BUN elevated which urea is the byproduct of protein breakdown.
    Hope I helped^^:heartbeat

  4. -> Continue reading
read more

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