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Dka Pathophysiology Nursing

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Diabetic Ketoacidosistreatment & Management

Diabetic KetoacidosisTreatment & Management Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Managing diabetic ketoacidosis (DKA) in an intensive care unit during the first 24-48 hours always is advisable. When treating patients with DKA, the following points must be considered and closely monitored: Correction of fluid loss with intravenous fluids Correction of electrolyte disturbances, particularly potassium loss Treatment of concurrent infection, if present It is essential to maintain extreme vigilance for any concomitant process, such as infection, cerebrovascular accident, myocardial infarction, sepsis, or deep venous thrombosis . It is important to pay close attention to the correction of fluid and electrolyte loss during the first hour of treatment. This always should be followed by gradual correction of hyperglycemia and acidosis. Correction of fluid loss makes the clinical picture clearer and may be sufficient to correct acidosis. The presence of even mild signs of dehydration indicates that at least 3 L of fluid has already been lost. Patients usually are not discharged from the hospital unless they have been able to switch back to their Continue reading >>

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  1. jlr820, BSN

    Yes it is. The bloodstream is absolutely full of glucose (since it isn't entering cells and being metabolized). This glucose load makes the blood HYPERosmolar and the kidneys respond by trying to remove glucose through urination. They cannot effectively deal with the large glucose load, and that's why glucose "spills" into the urine. The process of excessive urine output secondary to the large glucose load is called osmotic diuresis, and the client loses a HUGE amount of fluid through this diuretic effect, leading to profound dehydration.

  2. NRSKarenRN

    check out these prior posts:
    question about dka - nursing for nurses
    nursing interventions - nursing for nurses
    clincal articles:
    diabetic ketoacidosis: emedicine pediatrics: cardiac disease and
    diabetic ketoacidosis: emedicine endocrinology
    how do i care for a patient with diabetic ketoacidosis
    dka nursing care plan
    acccn's critical care nursing - google books result

  3. ghurricane

    Thanks so much!! Here is another oddity that makes no sense. I know there is potassium depletion due to frequent urination, but why do labs usually indicate hyperkalemia?

  4. -> Continue reading
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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high b

Diabetic Ketoacidosis: Rapid Identification, Treatment, And Education Can Improve Survival Rates.

The rescue squad arrives at the emergency department (ED) with Chad Smith, 72 years old, who was found unconscious on the basement floor of his home. En route to the hospital, Mr. Smith's respirations became very shallow. An endotracheal tube was inserted, and its placement was confirmed by end-tidal CO2 detection. Since arriving at the ED, he has remained comatose and is not assisting the ventilator. His vital signs are blood pressure, 80/48 mmHg; heart rate, 112 beats per minute; and temperature, 91.8°F. He has a sinus tachycardia without ectopy. The glucometer indicates a finger stick blood sugar (FSBS) reading of “panic high.” Mr. Smith is among the 5.9% of people in the United States with diabetes. 1 A significant percentage of them will experience diabetic ketoacidosis (DKA), a state of hyperglycemia, hyperketonemia, and metabolic acidosis. 2,3 DKA typically affects those with type 1 diabetes, although patients with type 2 diabetes who suffer from hyperglycemic hyperosmolar nonketotic syndrome also experience DKA, and with increasing incidence. 4,5 In January 2002, the American Diabetic Association (ADA) reported that there are approximately 100,000 hospitalizations for Continue reading >>

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Popular Questions

  1. jlr820, BSN

    Yes it is. The bloodstream is absolutely full of glucose (since it isn't entering cells and being metabolized). This glucose load makes the blood HYPERosmolar and the kidneys respond by trying to remove glucose through urination. They cannot effectively deal with the large glucose load, and that's why glucose "spills" into the urine. The process of excessive urine output secondary to the large glucose load is called osmotic diuresis, and the client loses a HUGE amount of fluid through this diuretic effect, leading to profound dehydration.

  2. NRSKarenRN

    check out these prior posts:
    question about dka - nursing for nurses
    nursing interventions - nursing for nurses
    clincal articles:
    diabetic ketoacidosis: emedicine pediatrics: cardiac disease and
    diabetic ketoacidosis: emedicine endocrinology
    how do i care for a patient with diabetic ketoacidosis
    dka nursing care plan
    acccn's critical care nursing - google books result

  3. ghurricane

    Thanks so much!! Here is another oddity that makes no sense. I know there is potassium depletion due to frequent urination, but why do labs usually indicate hyperkalemia?

  4. -> Continue reading
read more
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DKA (Diabetic Ketoacidosis) Vs HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome) Tables From Step Up to Medicine (3rd Edition, Agabegi) Here is the link for the Quick Hits =) http://imgur.com/TnJPBmu

4 Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Nonketotic Syndrome Nursing Care Plans

Risk for Fluid Volume Deficit: At risk for experiencing vascular, cellular, or intracellular dehydration. Risk Factors Decreased intake of fluids due to diminished thirst sensation or functional inability to drink fluids. Excessive gastric losses due to nausea and vomiting. Hyperglycemia-induced osmotic diuresis. Possibly evidenced by [not applicable]. Desired Outcomes Client will remain normovolemic as evidenced by urinary output greater than 30 ml/hr, normal skin turgor, good capillary refill, normal blood pressure, palpable peripheral pulses, and blood glucose levels between 70-200 mg/dL. Nursing Interventions Rationale Assess precipitating factors such as other illnesses, new-onset diabetes, or poor compliance with treatment regimen. These will provide baseline data for education once with resolved hyperglycemia. Urinary tract infection and pneumonia are the most common infections causing DKA and HHNS among older clients. Assess skin turgor, mucous membranes, and thirst. To provide baseline data for further comparison. Skin turgor will decrease and tenting may occur. The oral mucous membranes will become dry, and the client may experience extreme thirst. Monitor hourly intake a Continue reading >>

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Popular Questions

  1. jlr820, BSN

    Yes it is. The bloodstream is absolutely full of glucose (since it isn't entering cells and being metabolized). This glucose load makes the blood HYPERosmolar and the kidneys respond by trying to remove glucose through urination. They cannot effectively deal with the large glucose load, and that's why glucose "spills" into the urine. The process of excessive urine output secondary to the large glucose load is called osmotic diuresis, and the client loses a HUGE amount of fluid through this diuretic effect, leading to profound dehydration.

  2. NRSKarenRN

    check out these prior posts:
    question about dka - nursing for nurses
    nursing interventions - nursing for nurses
    clincal articles:
    diabetic ketoacidosis: emedicine pediatrics: cardiac disease and
    diabetic ketoacidosis: emedicine endocrinology
    how do i care for a patient with diabetic ketoacidosis
    dka nursing care plan
    acccn's critical care nursing - google books result

  3. ghurricane

    Thanks so much!! Here is another oddity that makes no sense. I know there is potassium depletion due to frequent urination, but why do labs usually indicate hyperkalemia?

  4. -> Continue reading
read more

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