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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:
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    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?

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