How Does Ketoacidosis Cause Dehydration

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Fluid Management In Diabetic Ketoacidosis

Young people with insulin dependent diabetes mellitus are three times more likely to die in childhood than the general population.1 Despite advances in management over the past 20 years, the incidence of mortality associated with diabetic ketoacidosis (DKA) remains unchanged. Cerebral oedema is the predominant cause of this mortality; young children are particularly at risk, with an incidence of 0.7–1% of episodes of DKA.2,3 The mortality appears to be greatest among patients at first presentation,1,3,4 if there has been a long history of symptoms prior to admission,3 and during the first 24 hours of treatment.4 In a recently published retrospective multicentre analysis of children with DKA, low pco2 levels and high serum sodium concentration at presentation were identified as particular risk factors for the development of cerebral oedema, together with bicarbonate therapy.5 However, in the accompanying editorial, Dunger and Edge point out that this may simply be revealing an association between severe DKA and dehydration and the risk of cerebral oedema.6 The pathogenesis of cerebral oedema remains poorly understood but there may be many contributing factors.7 The aim of manageme 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?

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