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How Can Dka Be Avoided?

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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...

How To Avoid Diabetic Ketoacidosis (dka)

It might have been a really long time since you’ve been in diabetic ketoacidosis (DKA), or maybe you’ve never had it. But if you have Type 1 diabetes, you are at risk. Sometimes when you haven’t recently experienced a situation, you kind of forget about what you were told to do for prevention or treatment. That’s why a refresher might be a great idea! Signs you are experiencing diabetic ketoacidosis: If you are in DKA, it’s likely that you are nauseous or vomiting. Your breath may have a fruity or acetone odor as your body tries to offload ketones through your breathing. It’s likely that you will be dehydrated with very high BG levels and excessive urination. You might have aches and pains, and perhaps blurred vision. Not fun. DKA is serious, and can be life-threatening. Because of dehydration and excessive ketone production, the blood becomes acidic. This is caused by a lack of working insulin. Most cells preferentially burn glucose for fuel. Many cells can also burn fat in small amounts. While glucose burns “cleanly,” fat produces waste products called ketones. Ketones are acid and upset the pH balance, essentially polluting the atmosphere in our bodies. We don’ Continue reading >>

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  1. gaijinrussell57

    I am 6'3, 265 lb., about 32% body fat, 55 years old.
    I have been eating a pretty clean ketogenic diet for the past week. Here's my average daily macronutrients breakdown as calculated on MyPlate:
    Calories - 2,000
    Protein - 180g (50g from whey isolate, 28g from eggs, 21g from cheese, and the rest from beef, chicken, fish)
    Fat - 110g (15g from avocado, 20g from eggs, 27g from cheese, 16g from almonds, and the rest from coconut oil, olive oil, beef, chicken, fish)
    Carb - 15g net (mostly from fiber supplement, green foods supplement, almonds, avocado)
    I do one hour weightlifting four days a week, and 60-90 minutes of cardio walking the remaining three days.
    After a week I tested my urine with a ketostix, and it measured zero ketones.
    I am thinking that I should have registered ketones by now.
    I drink a 42oz diet coke every day, and another 32oz of crystal light each day. I wonder if the artificial sweeteners may be screwing up my insulin response and keeping me from getting into ketosis.
    I'd appreciate any thoughts on what I should be doing differently to get ketosis kicked off.

  2. Minolwen

    If you are actually counting calories and macros accurately then your diet is clean and there isn't much reason for you not to enter into ketosis.
    What time of day are you testing yourself? It is possible that if you're testing post-workout and you workout pretty intensive that the ketostix will not show a trace. Next time you test do so right before bed or in the morning when you wake up and see if that makes a difference.
    It initially took me for 4-5 days to enter ketosis which sucked on CKD, which lead me to reading deeper into how the keto diet works. From this I learned I was on the wrong version of keto to begin with and now I'm much happier going the SKD route (fat burning). I'll probably switch back to CKD for bulking starting in August.

  3. calutaxi

    If this is your first time doing keto it can take you longer to adapt. Are you getting any of the symptoms of the keto flu?
    You CAN be in ketosis without showing on the ketostix. They can be a little finicky sometimes depending on hydration. If you're gonna use the sticks, use them first thing in the morning.

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What is CHROMIUM DEFICIENCY? What does CHROMIUM DEFICIENCY mean? CHROMIUM DEFICIENCY meaning - CHROMIUM DEFICIENCY definition - CHROMIUM DEFICIENCY 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... Chromium deficiency is a disorder that results from an insufficient dietary intake of chromium. It is an uncommon condition. Clear cases of deficiency have been observed in hospital patients who were fed defined liquid diets intravenously for long periods of time. The US dietary guidelines for adequate daily chromium intake were lowered in 2001 from 50200 g for an adult to 3035 g (adult male) and to 2025 g (adult female). These amounts were set to be the same as the average amounts consumed by healthy individuals. Consequently, it is thought that few Americans are chromium deficient. Approximately 2% of ingested chromium(III) is absorbed, with the remainder being excreted in the feces. Amino acids, vitamin C and niacin may enhance the uptake of chromium from the intestinal tract. After absorption, this metal accumulates in the liver, bone, and spleen. Trivalent chromium is found in a wide range of foods, including whole-grain products, processed meats, high-bran breakfast cereals, coffee, nuts, green beans, broccoli, spices, and some brands of wine and beer. Most fruits and vegetables and dairy products contain only low amounts. Most of the chromium in people's diets comes from processing or storing food in pans and cans made of stainless steel, which can contain up to 18% chromium. The amount of chromium in the body can be decreased as a result of a diet high in simple sugars, which increases the excretion of the metal through urine. Because of the high excretion rates and the very low absorption rates of most forms of chromium, acute toxicity is uncommon. The symptoms of chromium deficiency caused by long-term total parenteral nutrition are severely impaired glucose tolerance, weight loss, and confusion. However, subsequent studies questioned the validity of these findings. Some researchers contend that chromium is not an essential nutrient, that chromium has no beneficial effects on body mass or composition and should be removed from the list of essential trace elements. The proposed mechanism for cellular uptake of CrIII via transferrin has also been called into question. A natural form of chromium extracted from yeast, Glucose Tolerance Factor (GTF) chromium, was found to exert beneficial insulin-mimetic and insulin-potentiating effects in vitro and in a mouse model the GTF form was seen to produce an insulin-like effect by acting on cellular signals downstream of the insulin receptor. These beneficial results were seen to suggest Glucose Tolerance Factor as a potential source for a novel oral medication for diabetes. However, recent studies in humans "have concluded that chromium supplements have no demonstrated effects on healthy individuals" and chromium picolinate in particular is described as a "poor choice" as a supplement. A 2007 review concluded that chromium supplements had no beneficial effect on healthy people, but that there might be an improvement in glucose metabolism in diabetics, although the authors stated that the evidence for this effect remains weak. Although it is controversial whether oral supplements should be taken by healthy adults eating a normal diet, chromium is needed as an ingredient in total parenteral nutrition, since deficiency can occur after months of intravenous feeding with chromium-free TPN. For this reason, chromium is added to normal TPN solutions, even though trace amounts found even in "chromium free" preparations may be enough to prevent deficiency in some individuals, and recent studies have challenged the methodology of earlier studies, concluding that chromium should not be regarded as an essential element.

Dka: How To Avoid A Severe Complication Of Insulin Deficiency

To understand DKA, it is first necessary to understand how our body uses glucose for energy and the role that insulin plays in that process. When we eat, food gets broken down into glucose (commonly called sugar), which is then released into the bloodstream. Insulin that is produced by the pancreas in healthy individuals then helps transport the glucose into our cells, where it is used as an energy source. DKA occurs when the body lacks enough insulin to help the glucose enter the cells, resulting in the glucose getting stuck in the circulatory system. Consequently, the body eliminates the glucose via urine, along with much-needed water and electrolytes such as salt and potassium, ultimately causing dehydration. As a result, the person with DKA is thirsty, urinates frequently and is at risk for severe complications resulting from electrolyte imbalances. At the same time, the body’s glucose-starved cells resort to burning body fat for fuel. And when that fat is broken down, the chemical byproducts of the fat-burning process – ketones – build up in the blood and urine, which can make the blood more acidic, cause organ dysfunction and ultimately lead to life-threatening complica Continue reading >>

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  1. leeleelee

    I have been water fasting for 4 days so far (my goal is 40 days) but am finding myself a little hungry..
    what types of things can I drink that will not cause me to loose the ketosis I am in?
    Thanks

  2. givemehipbones_

    Story if this sounds dumb but what is ketosis?

  3. leeleelee

    From what I understand It's a state where your body burns excess fat for fuel and not muscle or any other foods that you have recently eaten... usually occurs during fasting!!!

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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 blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, s Continue reading >>

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  1. Michael Simpson

    Diabetic ketoacidosis (the formal name, and the one most diabetics use, abbreviating it as DKA) can happen in Type 2 diabetics, but as you implied it is rare.
    Type 1 diabetics totally lack or have insufficient amounts of insulin. So the body produces the antagonistic hormone, glucagon, because there's no insulin, which to the body means there's low glucose. Glucagon then induces the liver to use fat as energy, producing ketone bodies while also forcing the liver to convert glycogen to glucose. Unfortunately, the blood glucose levels are high because the Type 1 Diabetic has no insulin. This causes the blood osmolarity to skyrocket, and the kidneys try to compensate by removing ketones and glucose from the blood.
    Since the kidneys have a maximum capacity to clear excess glucose from the blood, the blood becomes more acidotic and ketone bodies rise at the same time. And that leads to more serious issues like coma and death.
    The feedback systems are all broken, so the body spins out of control. It is often the first sign of Type 1 diabetes.
    So the one difference between Type 1 and Type 2 diabetics is that Type 1 has no insulin, but Type 2 generally has insulin in the blood to suppress the release of glucagon. And this is why it's rare in Type 2 diabetics.

  2. Liang-Hai Sie

    We need insulin to be able to utilize glucose, type 2 has some insulin, not enough because of the insulin resistance, type 1 don't, so in type one ketosis can develop because the lack of insulin causes the body to burn fat that forms ketones if no inslin is administered. I knew a man who every time he was arrested by intent "forgot" to inject his insulin so ended in hospital with a keto-aciditic diabetic coma, out of jail.

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