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Dka Simplified

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https://metabolicfuel.pruvitnow.com The clinical utility of beta hydroxybutyrate is an analyte in the laboratory so the first case i want to cover is actually a pediatric 13 year old Caucasian female. She's overweight has no past medical history family history of type 1 diabetes and she's going to her primary care practitioner with the two-week history of polydipsia polyuria a 20-pound weight loss. She seems not too big to complain to the primary care practitioner was she can get enough to drink she was waking up several times at night to urinate and at the physician's office she had a capillary glucose of about 440 4 milligrams per deciliter and your analysis done at the physician's office was a 4 plus ketones, so she was transferred to our emergency department and her ph was low she was acid addict had a high serum glucose. Her bicarb was very low so sure anion gap was up she had a high beta hydroxybutyrate it was 8.46 and the normal range for those of you who aren't familiar with it is 0-2 0.27 millimoles per liter. So this was orders of magnitude above the normal range and her sodium was 137 141. When you correct it for hyperglycemia now the second case we want to talk about is

Bedside Monitoring Of Blood Β-hydroxybutyrate Levels In The Management Of Diabetic Ketoacidosis In Children

Arleta Rewers, M.D., Ph.D.Kim McFann, Ph.D. The Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Denver, Colorado. H. Peter Chase, M.D. The Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Denver, Colorado. Introduction: Diabetic ketoacidosis (DKA) affects many children with type 1 diabetes. Insulin treatment of DKA is traditionally guided by changes in the blood glucose levels and blood gases, whereas β-hydroxybutyrate (β-OHB)—the main ketoacid causing acidosis—is rarely measured. The purpose of this study was to evaluate if bedside monitoring of blood β-OHB levels can simplify management of DKA through elimination of superfluous laboratory monitoring. Methods: Our emergency department treated 68 children with DKA using a standard protocol with monitoring of venous pH, partial pressure of CO2 (pCO2), bicarbonate, glucose, blood urea nitrogen, and electrolytes (two to 10 time points per patient). Venous β-OHB levels were measured using the Precision Xtra™ meter (MediSense/Abbott Diabetes Care, Abbott Park, IL) and, on duplicate batched serum samples, using a r Continue reading >>

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  1. Linnie

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  3. Mary

    Forget anything you have ever been told about Diabetes. And get this - it has nothing to do with insulin, exercise, diet or anything else you've heard in the past. It's all based on latest breakthrough research that Big Pharma is going Stir Crazy to hide from you. Visit here : https://tinyurl.im/aH1RU to find out what all the fuss is about.

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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

Diabetic Ketoacidosis (dka), Brief Description, Diagnosis And Management Simplified

Diabetic ketoacidosis (DKA) is a potentially life threatening complication of diabetes mellitis. DKA occurs predominantly in patients with type 1 diabetes and may be the presenting manifestation. It can also occur in patients with type 2 diabetes under certain circumstances. It results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies that cause most of the signs and symptoms. ETIOLOGY: DKA results from insulin insufficiency with a relative or absolute increase in glucagon and may be caused by insufficient or interrupted insulin therapy, infections (pneumonia, urinary tract infection, gastroenteritis, sepsis), infarction (cerebral, coronary, mesenteric, peripheral), emotional stress, excessive alcohol intake, surgery, pregnancy and trauma, and certain drugs such as steroids, cocaine etc. CLINICAL PRESENTATION: DKA clinically presents as polydypsia (excessive intake of fluid due to pronounced thirst), polyuria (excessive urination) anorexia (loss of appetite), nausea or vomiting, abdominal pain, rapid breathing (kussmaul respiration), fruity breath odor of acetone, fever, tachycardia, hypotension, signs of dehydratio Continue reading >>

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  1. DARTHgrue

    I adopted a low-carb diet a while ago, and ever since I went into ketosis I have had the worst insomnia of my life. I usually struggle with severe insomnia, but this is radical - drinking large amounts of alcohol (only thing that seems to help) buys me ~3hrs, otherwise I just DON'T SLEEP. I'm having extreme anxiety and panic attacks because my brain just never gets a break. Someone gave me a Xanax the other day, and I got two restless, fitful hours of nap time. My question is, how long do I put up with this before I can determine if I will acclimate or if this will be a permanent effect of this diet and I need to abandon it? I know it's pretty early on and my body can probably adjust, but this is severely effecting every area of my life and taking a significant toll on my mental health. Anyone else experience this? Please advise!

  2. Ctrl-Z

    Not insomnia so much, but I can see how if you have anxiety problems and are stimulant-sensitive (as I am), the energy ketones give may seem a bit extreme and give you almost too much energy. I definitely have a hard time falling asleep at night on keto vs. not. I figure after doing it for long enough you'll get used to it.

  3. naygor

    I'm not a licensed doctor, so take my advice with a grain of salt:
    Have you struggled with stress/anxiety/depression before keto? I mean, are you under a lot of stress in general? You kind of sound like me a few months ago.
    It sounds like you're having trouble getting enough serotonin. When this happends, you're prone to panic attacks, negative thinking, lacking in restful sleep, and your train of thoughts seems to go a million times a minute. If your brain chemistry isn't right, like in my case, keto can exasperate your problems. I'm not saying keto is the ultimate cause of your problems, just that it can in some cases it doesn't help much. Eating meals large in protein as you do in keto increases the amount of amino acids in the blood, making it less likely for the precursor to serotonin, tryptophan, to cross the blood brain barrier. Consider dropping keto altogether until you get your mental health in check. You might have to make some radical changes to get your life straight again. I did. I was suffering from extremely crippling depression/anxiety and other symptoms like yours and had to take few months off of school to recuperate. I am 100% better now after seeing a naturopath and am doing keto now without too many hiccups.
    Here is what seeing the naturopath did for me:
    I got my neurotransmitter levels tested (serotonin, dopamine, gaba stuff) and all came out to be way lower than normal. There are supplements you can take to remedy this. I was put on some propriety supplements by a company called sanesco: Prolent (for serotonin, whose active ingredient is just 5-HTP), and Lentra (for gaba/dopamine, which has theraputic dosage of magnesium, taurine, and L-theanine).
    Also, my vitamin D levels, which are important in the conversion of tryptophan to serotonin, were low. I had to supplement with that as well. Getting enough sunlight also helps with this.

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Watch as I take you down my Critical Thinking Journey!!!! What is DKA? Remember its a life threatening complication in patients with Diabetes when theres a major deficiency of insulin. This leads the body to starve and burn fatty acids causing the individual to go into a Metabolic Acidotic state leading to coma... Vine: Nursemendoza2 Twitter: Nursemendoza2 Instagram: Nursemendoza2 Disclaimer: No content contained herein is meant to be representative of our or any other institution. The opinions expressed in this video on this channel are not necessarily of those hospitals where I work, or their affiliated institutions. The views expressed on this channel and/or in the videos on this channel do not represent medical advice- if you have specific medical concerns please contact your doctor. In order to protect patient privacy all patient identifiers in all videos have been deleted or altered. The views expressed on this channel and/or on the videos on this channel are opinions.

Diabetic Ketoacidosis (dka) Simplified

Watch as I take you down my Critical Thinking Journey!!!! What is DKA? Remember its a life threatening complication in patients with Diabetes when theres a major deficiency of insulin. This leads the body to starve and burn fatty acids causing the individual to go into a Metabolic Acidotic state leading to coma... Vine: Nursemendoza2 Twitter: Nursemendoza2 Instagram: Nursemendoza2 Disclaimer: No content contained herein is meant to be representative of our or any other institution. The opinions expressed in this video on this channel are not necessarily of those hospitals where I work, or their affiliated institutions. The views expressed on this channel and/or in the videos on this channel do not represent medical advice- if you have specific medical concerns please contact your doctor. In order to protect patient privacy all patient identifiers in all videos have been deleted or altered. The views expressed on this channel and/or on the videos on this channel are opinions. Nursemendoza2, Diabetic Ketoacidosis, Diabetes, DM, Diabetic, Type 1 Diabetic, Type 2 Diabetic, Clinical Emergency, Elevated Blood sugar, insulin deficiency, Insulin hormone, pancreas, Male Nurse, Murse, Studen Continue reading >>

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  1. derphamster

    Yes you were on the way to DKA, because you are not producing enough insulin to meet your body's needs whilst working out.
    You can go into DKA without your blood sugars being high if you have a mismatch in insulin requirement vs insulin output. The normal/low blood sugar DKA is quite rare but it can happen if the circumstances are right. You did the right thing to fight it, by having some carbs and protein and drinking a lot of water. If it repeats and you can't get the ketones down and you feel unwell you need to go to hospital. DKA can put you in a coma within hours so you need to take it seriously.
    I'd try to ease off doing hard workouts. You can still exercise but if this happens again you should rethink. You can also use this to back up your story at the doctors.

  2. joralo

    Thank you derphamster, you always give great advice in all of my threads. :) Now I'm even more scared....I feel even more wary of the oGTT now, I shouldn't take it if I react this badly. If I am on my way to DKA with just some exercise and not much food - how will I react when downing 75 g of glucose? Probably straight to DKA... I really don't know what to do, other than sit around and wait until I actually develop whatever form of diabetes I have - so that some doctor will finally help me out and take me seriously. Even if I took the oGTT - what if it's one of those rare unpredictable days where my body still handles it and at the 2nd hour it is < 200...I will be sent home as "glucose intolerant" and would still be none the wiser. This limbo state truly sucks, sorry had to vent.

  3. derphamster

    Don't worry, ogtt won't cause you to go into DKA. You'll still be making the same amount of insulin, which is obviously enough for normal activities (evidenced by your normal readings most of the time). DKA occurs not from high blood sugar, but from not having enough insulin for your needs. The reason you got ketones when you were exercising is that a workout drastically increases the body's need for insulin as there are hundreds of hungry muscles competing for fuel, which is delivered by insulin. When insulin can't keep up, the body must burn fat for fuel which generates ketones.
    I also forgot to mention that your lack of food (specifically, carbs) before your workout could also cause your body to produce more ketones due to not enough glucose. If you'll be doing something strenuous, consider having a 10-15g carb snack shortly beforehand.
    The high blood sugar normally associated with DKA is a result of too little insulin for the body's basic function, so even though a person is eating carbs, the sugar just stays in the blood and builds up to a high level. The high blood sugar is a symptom, not a cause.

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