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Pathophysiology Of Diabetic Ketoacidosis Ppt

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25-40% Of Newly Diagnosed Cases Present In Dka

Case Scenario #1 What is your assessment? DKA exists when: Venous pH < 7.3 Serum bicarbonate < 15 mEq/dL Blood glucose > 300 mg/dL Presence of ketonemia/ketonuria How much fluid would you administer as a bolus? Would you administer bicarbonate? How much insulin would you administer? What IVF would you start? At what rate? * 10 - 20 cc/kg bolus of NS would be adequate. Though the patient is dehydrated (dry lips), his hemodynamics are good, with acceptable vitals and good perfusion. There would be no reason to administer more than 20 cc/kg fluids. While this patient is clearly acidemic, he is NOT in impending cardiovascular collapse and therefore there is no justification for the administration of bicarbonate. In fact, administration of bicarbonate has been associated with the development of cerebral edema. The “true†serum sodium is 143 133 + 0.016[700-100] Insulin is generally started at 0.1 u/kg/hr. Therefore, in this 30 kg patient, an insulin infusion of 3 u/hr of regular insulin should be initiated. IVF of NS should be started at ~ 2400 cc/m2/day, which is approximately 1.5 x maintenance Continue reading >>

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Popular Questions

  1. carlabul

    What is the difference between humulin r and humulin n?

    What is the difference between humulin r and humulin n?

  2. PS Psyched

    Carlabul,
    The difference is their reaction times. Humulin R is short acting insulin, regular and it begins to work within 30 minutes of administering it, peaks at 2.5 to 5 hours, and lasts up to 6 hours. Humulin N is intermediate acting insulin in an isophane suspension-it begins working 1.5 to 4 hours after administering it, peaks 4-12 hours, and can last up to 24 hours in the body. Hope this helps.

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