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Pediatric Dka Case Scenario

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In this video, Dr. Michael Agus discusses the risk factors, signs, symptoms, and treatment of cerebral edema in diabetic ketoacidosis. Please visit: www.openpediatrics.org OPENPediatrics is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: [email protected] Please note: OPENPediatrics does not support nor control any related videos in the sidebar, these are placed by Youtube. We apologize for any inconvenience this may cause.

High Fidelity Simulation Case: Teaching Diabetic Ketoacidosis With Cerebral Edema

High Fidelity Simulation Case: Teaching Diabetic Ketoacidosis with Cerebral Edema To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications. Diabetic ketoacidosis is a common complaint throughout the emergency departments of the United States. However, the subsequent development of cerebral edema is a rarely encountered and critical clinical entity. Though residents and medical students have a great deal of exposure through their clinical time to diabetic ketoacidosis, very few have the opportunity to witness the development of cerebral edema and aid in its management. It is for this reason that this simulation has been developed to prepare the learner for the actual disease process should it occur. This simulation case goes through the recognition and management of this challenging condition. The learner should demonstrate expected competencies in the management of both clinical entities however the primary focus is in the simulation of the development and subsequent management of cer Continue reading >>

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Popular Questions

  1. AbbaZabba

    OK So I was trying to learn more about Ketosis and came across a forum where a guy claimed you could reach ketosis in just 24hours of water fasting. I really wish I could start it right now but I already had a cliff bar today so I may not start this until this weekend but here is what you do.
    - The day before you want to start your water fast you eat only fruit, so that is the only carbs and glucose in your system. He says to preferably eat it for 2-3 days in advance.
    - On Day 1 of the fast you drink 8oz of orange juice and then you walk for 2-3 hours or around 5-6.5 miles. He claims this will burn all of your carb reserves and go directly into ketosis by the next morning.
    - After the first day you do not exercise and just continue on to the normal water only fast.
    I need a weekend day to be able to walk around for 3 continuos hours & a few days planning so I think I am going to try and start fruit fasting tomorrow or Thursday and then start the fast Saturday. I really want to get into Ketosis for awhile because I have plenty of fat to burn. I am also a highly toxic person and I know this so it would be nice to really flush stuff out.
    If anyone wants to trade kik names & join me this weekend hit me up!
    Here is the link where I found this stuff: http://www.stevepavl...s-24-hours.html

  2. Caliico

    Sounds a little complicated? You will reach ketosis within 24-48h by simply water fasting.

  3. xoxomelodie

    Yeah it's not a big secret. It's very easy after a day of fasting. Heck the hours of walking sound terrible to me. Maybe 30 mns of running or on the elliptical while fasting. Also, depending on how long you're planning on water fasting, you will barely be able to do anything and you will lose all muscle mass. Plus fasting/juicing does not make you detoxify.
    I mean, don't get me wrong. I've done this before successfully so you will shed weight but better have the facts. And if you ever feel you're getting too weak, just remember just some protein and fat can go a long way in strengthening your resolve and it will not ruin the diet.

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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...

Diabetic Emergencies, Part 5: Dka Case Studies

Case Study 1 A 32-year-old male with type 1 diabetes since the age of 14 years was taken to the emergency room because of drowsiness, fever, cough, diffuse abdominal pain, and vomiting. Fever and cough started 2 days ago and the patient could not eat or drink water. He has been treated with an intensive insulin regimen (insulin glargine 24 IU at bedtime and a rapid-acting insulin analog before each meal). On examination he was tachypneic, his temperature was 39° C (102.2° F), pulse rate 104 beats per minute, respiratory rate 24 breaths per minute, supine blood pressure 100/70 mmHg; he also had dry mucous membranes, poor skin turgor, and rales in the right lower chest. He was slightly confused. Rapid hematology and biochemical tests showed hematocrit 48%, hemoglobin 14.3 g/dl (143 g/L), white blood cell count 18,000/ μ l, glucose 450 mg/dl (25.0 mmol/L), urea 60 mg/dl (10.2 mmol/L), creatinine 1.4 mg/dl (123.7 μ mol/L), Na+ 152 mEq/L, K+ 5.3 mEq/L, PO4 3−2.3 mEq/L (0.74 mmol/L), and Cl− 110 mmol/L. Arterial pH was 6.9, PO 2 95 mmHg, PCO 2 28 mmHg, HCO 3−9 mEq/L, and O 2 sat 98%. The result of the strip for ketone bodies in urine was strongly positive and the concentration Continue reading >>

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Popular Questions

  1. FatJessica

    > Ketosis taste in mouth?

    I caught a glimpse of a thread somewhere mentioning a taste in the mouth that some people get when they are in ketosis....anyone know what I'm talking about?

  2. MorganMac

    Yep, it's rather common. Ketone bodies (such as acetone) are excreted from the body in the breath and urine. Many people get "keto breath" for awhile when they start a LC diet :)

  3. FatJessica

    What does it smell like?

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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.....

Pediatric Diabetic Ketoacidosis

Pediatric Diabetic Ketoacidosis Authors: Katia M. Lugo-Enriquez, MD, FACEP, Faculty, Florida Hospital Emergency Medicine Residency Program, Orlando, FL. Nick Passafiume, MD, Florida Hospital Emergency Medicine Residency Program, Orlando, FL. Peer Reviewer: Richard A. Brodsky, MD, Pediatric Emergency Medicine, St. Christopher's Hospital for Children, Assistant Professor, Drexel University, Philadelphia, PA. Children with diabetes, especially type 1, remain at risk for developing diabetic ketoacidosis (DKA). This may seem confounding in a modern society with such advanced medical care, but the fact remains that children who are type 1 diabetics have an incidence of DKA of 8 per 100 patient years.1 In fact, Neu and colleagues have noted in a multicenter analysis of 14,664 patients in Europe from 1995 to 2007 that there was no significant change in ketoacidosis presenting at diabetes onset in children.2 In children younger than 19 years old, DKA is the admitting diagnosis in 65% of all hospital admissions of patients with diabetes mellitus.3 This article reviews the presentation, diagnostic evaluation, treatment, and potential complications associated with pediatric DKA. — The Editor Continue reading >>

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Popular Questions

  1. Inkey-2008

    My wife and I have been low carbing for over month.
    I use keto sticks and have been in ketosis since the end of the first week.
    I was using MFP to monitor what we are eating And it says we should be losing weight,
    I have weighed out food etc used the bar code scanner which is good. But the weight will not move. (
    We have eggs bacon mushrooms cooked in butter.
    lunch is salad with fish or ham with mayo and coleslaw
    dinner tonight was 2 small pork belly slices grilled, mix veg stir fry.
    coffee with double cream
    fruit berries in sugar free jelly with double cream.
    Our only direct carbs are from milk.
    most days carbs are below 20
    We are thinking of cutting back the protien by going veggie at lunch and dinner a couple of days a week.
    Andy

  2. carol anne

    Inkey-2008 said: ↑
    My wife and I have been low carbing for over month.
    I use keto sticks and have been in ketosis since the end of the first week.
    I was using MFP to monitor what we are eating And it says we should be losing weight,
    I have weighed out food etc used the bar code scanner which is good. But the weight will not move. (
    We have eggs bacon mushrooms cooked in butter.
    lunch is salad with fish or ham with mayo and coleslaw
    dinner tonight was 2 small pork belly slices grilled, mix veg stir fry.
    coffee with double cream
    fruit berries in sugar free jelly with double cream.
    Our only direct carbs are from milk.
    most days carbs are below 20
    We are thinking of cutting back the protien by going veggie at lunch and dinner a couple of days a week.
    Andy
    Click to expand... All the fats in your diet are calories so how can you lose weight is cream butter belly pork lean meat olive oil skimmed milk is better

  3. Robbity

    carol anne said: ↑
    All the fats in your diet are calories so how can you lose weight is cream butter belly pork lean meat olive oil skimmed milk is better
    @carol anne - you need to read up on low carb high fat diets - plenty of people on this forum are losing weight this way, and it's an excellent diet for diabetics, because it also helps reduce high blood glucose levels. It's carbohydrates not fat that are the problem, and skimmed milk is full of carbohydrates, so isn't appropriate for this type of diet.
    @Inkey-2008 :
    It's possible to in ketosis and not lose weight - it's not of itself a weight loss diet - you still do need to take care of total calories. I know because I'm currently in this same position!
    Check with one of the keto specific nutritional calculators, e.g. http://www.phlaunt.com/diabetes/DietMakeupCalc.php or http://www.ruled.me/keto-calculator/, and see how they compare with what MFP is telling you. Jenny Ruhl's mini book advertised on the phlaunt calculator page may also be helpful.
    Maybe ditch the milk too for lactose free or something like Alpro unsweetened almond milk, and check carefully for hidden sugars in the mayo and coleslaw if they're not homemade.
    Robbity

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