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Electrolyte Imbalance In Diabetic Ketoacidosis

If you have diabetes, it's important to be familiar with diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes that occurs when lack of insulin and high blood sugar lead to potentially life-threatening chemical imbalances. The good news is DKA is largely preventable. Although DKA is more common with type 1 diabetes, it can also occur with type 2 diabetes. High blood sugar causes excessive urination and spillage of sugar into the urine. This leads to loss of body water and dehydration as well as loss of important electrolytes, including sodium and potassium. The level of another electrolyte, bicarbonate, also falls as the body tries to compensate for excessively acidic blood. Video of the Day Insulin helps blood sugar move into cells, where it is used for energy production. When insulin is lacking, cells must harness alternative energy by breaking down fat. Byproducts of this alternative process are called ketones. High concentrations of ketones acidify the blood, hence the term "ketoacidosis." Acidosis causes unpleasant symptoms like nausea, vomiting and rapid breathing. Bicarbonate is an electrolyte that normally counteracts blood acidity. In DKA, the bicarbonate Continue reading >>

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  1. dietcherry

    THE DANGERS OF DIABETIC KETOACIDOSIS

    This serious complication, the result of acid buildup in the blood, can lead to coma or even death.
    If you have type 1 diabetes, one of the serious complications you may face is a condition known as ketoacidosis. In diabetic ketoacidosis, acids called ketones build up in your blood and could eventually lead to diabetic coma or death.
    But by vigilantly controlling your diabetes and watching for early signs of ketoacidosis, you can help prevent it from happening to you.
    What Is Diabetic Ketoacidosis?
    "When blood sugars get elevated and there is not enough insulin, your fat cells start to break down their storage sites of energy, which are called ketones," says Jay Cohen, MD, medical director of the Endocrine Clinic and clinical assistant professor in the department of family medicine at the University of Tennessee. Ketones are acidic, and that acid builds up in your blood.
    Diabetic ketoacidosis is found more often in younger people than older people, and more often in women than in men. At least 20 percent of people learn they have diabetes after seeking medical care for complaints that turn out to be symptoms of ketoacidosis.
    Common Causes of Diabetic Ketoacidosis
    The three common causes of ketoacidosis are:
    Not enough insulin. This can happen if you don’t inject enough insulin or if your insulin needs increase in response to an illness such as a cold or the flu. Blood glucose can’t be used for energy without enough insulin to help in the process, so the body breaks down fat for energy and high ketone levels result.
    "Elevated blood sugars could be due to an infection or any other physical or emotional stress — good or bad," says Dr. Cohen. Unexpected increases in your blood glucose levels can increase your insulin needs. "You may have a certain amount of insulin that you usually use, but if you have an infection, you may need more insulin to help your body to improve blood sugars," Cohen explains.
    Not enough food intake. If you don’t eat enough, your body has to break down fat for energy, producing high ketone levels. This is particularly common in people who are sick and don't feel like eating.
    Low blood glucose levels. This situation can force your body to break down fat to use as energy, resulting in ketone production.
    Diabetic Ketoacidosis Symptoms
    Symptoms of ketoacidosis usually progress relatively slowly. But since diabetic ketoacidosis can be a life-threatening condition, it is important to seek medical help immediately if you experience any of its symptoms. These include:
    Excessive thirst
    Dry mouth
    Frequent urination
    Elevated blood glucose levels
    Elevated ketones in the urine
    Persistent fatigue
    Skin that is dry or flushed
    Nausea or vomiting
    Pain in your abdomen
    Shortness of breath
    A fruity smell to your breath (the result of elevated ketone levels)
    Inability to concentrate
    Confused state
    Preventing Diabetic Ketoacidosis
    Ask your endocrinologist how you can reduce your risk of developing diabetic ketoacidosis. It is often a good idea to use a home dipstick test to check for ketones in your urine when your blood glucose levels are high (over 240 milligrams per deciliter) and when you have an infection.
    Diabetes education also helps. One study found that hospital stays for ketoacidosis were reduced among a group of people who attended diabetes education classes.
    Managing Diabetic Ketoacidosis
    If think you may have ketoacidosis, it is essential to contact your doctor or get to the emergency room immediately.
    "If we can catch it early, with medicine and IV fluids, we can stop the diabetic ketoacidosis from progressing to severe dehydration," says Cohen. "Diabetic ketoacidosis, if severe and not treated aggressively, has about a 5 percent death rate, so you really want to get a handle on it rapidly."
    Remember that regularly monitoring your blood glucose levels, performing urine ketone tests as recommended, and recognizing symptoms that might indicate your ketone levels are high is the best approach to reducing your risk of diabetic ketoacidosis.
    From Everyday Health

  2. Gem93

    I recently had a friend that got DKA she only had ketones for a day and was bring violently sick she couldn't test for ketones as her strips were left at her uni campus and went home to visit her family for the weekend her mum was just about to leave to go get the strips when she said I don't feel well take me to hospital betime she got to hospital ( which is a 10 min drive from where she lives) her vains had short down and the only vain left was the one to her heart they had to cut her throat open to put in an insulin drip immediately and was put in intensive care her family was told she might not make it and that was from having ketone symptoms for just a few hours / day at the most .. This has woken me up to life alot Snd made me realise what can happen if you don't look after yourself

  3. dietcherry

    OMG Can you get her to join here so we may talk to her?

  4. -> Continue reading
read more
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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

How To Spot And Treat Diabetic Ketoacidosis (dka)

Even if you work hard at your diabetes management and use technology to help keep your numbers in range, you can still experience high blood glucose, which can escalate to diabetic ketoacidosis (DKA). While DKA can be scary if left untreated, it is preventable if you know what to look for and what to do. Senior District Clinical Manager, Melinda Turenne, BSN, RN, CDE, has more than 15 years of diabetes clinical experience. Today she shares some valuable DKA risk factors and prevention tips. Living with diabetes involves a lot of duties. You are checking your blood glucose (BG), counting your carbohydrates, exercising, and keeping doctors’ appointments. I am sure you remember your doctor or diabetes educator telling you to check for ketones too, right? Checking my what? One more thing to add to my to-do list! Yes, and here is WHY. What are ketones? Ketones are acid molecules produced when we burn fat for energy or fuel. As fat is broken down, ketones build up in the blood and urine. In high levels, ketones are toxic and can make you very sick. When combined with dehydration, it can lead to Diabetic Ketoacidosis (DKA), a life threatening condition. Why would DKA happen? DKA occurs Continue reading >>

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Popular Questions

  1. dietcherry

    THE DANGERS OF DIABETIC KETOACIDOSIS

    This serious complication, the result of acid buildup in the blood, can lead to coma or even death.
    If you have type 1 diabetes, one of the serious complications you may face is a condition known as ketoacidosis. In diabetic ketoacidosis, acids called ketones build up in your blood and could eventually lead to diabetic coma or death.
    But by vigilantly controlling your diabetes and watching for early signs of ketoacidosis, you can help prevent it from happening to you.
    What Is Diabetic Ketoacidosis?
    "When blood sugars get elevated and there is not enough insulin, your fat cells start to break down their storage sites of energy, which are called ketones," says Jay Cohen, MD, medical director of the Endocrine Clinic and clinical assistant professor in the department of family medicine at the University of Tennessee. Ketones are acidic, and that acid builds up in your blood.
    Diabetic ketoacidosis is found more often in younger people than older people, and more often in women than in men. At least 20 percent of people learn they have diabetes after seeking medical care for complaints that turn out to be symptoms of ketoacidosis.
    Common Causes of Diabetic Ketoacidosis
    The three common causes of ketoacidosis are:
    Not enough insulin. This can happen if you don’t inject enough insulin or if your insulin needs increase in response to an illness such as a cold or the flu. Blood glucose can’t be used for energy without enough insulin to help in the process, so the body breaks down fat for energy and high ketone levels result.
    "Elevated blood sugars could be due to an infection or any other physical or emotional stress — good or bad," says Dr. Cohen. Unexpected increases in your blood glucose levels can increase your insulin needs. "You may have a certain amount of insulin that you usually use, but if you have an infection, you may need more insulin to help your body to improve blood sugars," Cohen explains.
    Not enough food intake. If you don’t eat enough, your body has to break down fat for energy, producing high ketone levels. This is particularly common in people who are sick and don't feel like eating.
    Low blood glucose levels. This situation can force your body to break down fat to use as energy, resulting in ketone production.
    Diabetic Ketoacidosis Symptoms
    Symptoms of ketoacidosis usually progress relatively slowly. But since diabetic ketoacidosis can be a life-threatening condition, it is important to seek medical help immediately if you experience any of its symptoms. These include:
    Excessive thirst
    Dry mouth
    Frequent urination
    Elevated blood glucose levels
    Elevated ketones in the urine
    Persistent fatigue
    Skin that is dry or flushed
    Nausea or vomiting
    Pain in your abdomen
    Shortness of breath
    A fruity smell to your breath (the result of elevated ketone levels)
    Inability to concentrate
    Confused state
    Preventing Diabetic Ketoacidosis
    Ask your endocrinologist how you can reduce your risk of developing diabetic ketoacidosis. It is often a good idea to use a home dipstick test to check for ketones in your urine when your blood glucose levels are high (over 240 milligrams per deciliter) and when you have an infection.
    Diabetes education also helps. One study found that hospital stays for ketoacidosis were reduced among a group of people who attended diabetes education classes.
    Managing Diabetic Ketoacidosis
    If think you may have ketoacidosis, it is essential to contact your doctor or get to the emergency room immediately.
    "If we can catch it early, with medicine and IV fluids, we can stop the diabetic ketoacidosis from progressing to severe dehydration," says Cohen. "Diabetic ketoacidosis, if severe and not treated aggressively, has about a 5 percent death rate, so you really want to get a handle on it rapidly."
    Remember that regularly monitoring your blood glucose levels, performing urine ketone tests as recommended, and recognizing symptoms that might indicate your ketone levels are high is the best approach to reducing your risk of diabetic ketoacidosis.
    From Everyday Health

  2. Gem93

    I recently had a friend that got DKA she only had ketones for a day and was bring violently sick she couldn't test for ketones as her strips were left at her uni campus and went home to visit her family for the weekend her mum was just about to leave to go get the strips when she said I don't feel well take me to hospital betime she got to hospital ( which is a 10 min drive from where she lives) her vains had short down and the only vain left was the one to her heart they had to cut her throat open to put in an insulin drip immediately and was put in intensive care her family was told she might not make it and that was from having ketone symptoms for just a few hours / day at the most .. This has woken me up to life alot Snd made me realise what can happen if you don't look after yourself

  3. dietcherry

    OMG Can you get her to join here so we may talk to her?

  4. -> Continue reading
read more
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Hyperglycemic crises: Hyperglycemic hyperosmolar nonketotic coma (HHNK) versus DKA. See DKA video here: https://youtu.be/r2tXTjb7EqU This video and similar images/videos are available for instant download licensing here https://www.alilamedicalmedia.com/-/g... Voice by: Penelope Hammet Alila Medical Media. All rights reserved. All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Support us on Patreon and get FREE downloads and other great rewards: patreon.com/AlilaMedicalMedia Hyperosmolar hyperglycemic state, or HHS, is another ACUTE and life-threatening complication of diabetes mellitus. It develops slower than DKA, typically in the course of several days, but has a much higher mortality rate. Like DKA, HHS is triggered when diabetic patients suffer from ADDITIONAL physiologic stress such as infections, other illness, INadequate diabetic treatment or certain drugs. Similar to DKA, the RISE in COUNTER-regulatory hormones is the major culprit. These hormones

Diagnosis And Treatment Of Diabetic Ketoacidosis And The Hyperglycemic Hyperosmolar State

Go to: Pathogenesis In both DKA and HHS, the underlying metabolic abnormality results from the combination of absolute or relative insulin deficiency and increased amounts of counterregulatory hormones. Glucose and lipid metabolism When insulin is deficient, the elevated levels of glucagon, catecholamines and cortisol will stimulate hepatic glucose production through increased glycogenolysis and enhanced gluconeogenesis4 (Fig. 1). Hypercortisolemia will result in increased proteolysis, thus providing amino acid precursors for gluconeogenesis. Low insulin and high catecholamine concentrations will reduce glucose uptake by peripheral tissues. The combination of elevated hepatic glucose production and decreased peripheral glucose use is the main pathogenic disturbance responsible for hyperglycemia in DKA and HHS. The hyperglycemia will lead to glycosuria, osmotic diuresis and dehydration. This will be associated with decreased kidney perfusion, particularly in HHS, that will result in decreased glucose clearance by the kidney and thus further exacerbation of the hyperglycemia. In DKA, the low insulin levels combined with increased levels of catecholamines, cortisol and growth hormone Continue reading >>

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Popular Questions

  1. dietcherry

    THE DANGERS OF DIABETIC KETOACIDOSIS

    This serious complication, the result of acid buildup in the blood, can lead to coma or even death.
    If you have type 1 diabetes, one of the serious complications you may face is a condition known as ketoacidosis. In diabetic ketoacidosis, acids called ketones build up in your blood and could eventually lead to diabetic coma or death.
    But by vigilantly controlling your diabetes and watching for early signs of ketoacidosis, you can help prevent it from happening to you.
    What Is Diabetic Ketoacidosis?
    "When blood sugars get elevated and there is not enough insulin, your fat cells start to break down their storage sites of energy, which are called ketones," says Jay Cohen, MD, medical director of the Endocrine Clinic and clinical assistant professor in the department of family medicine at the University of Tennessee. Ketones are acidic, and that acid builds up in your blood.
    Diabetic ketoacidosis is found more often in younger people than older people, and more often in women than in men. At least 20 percent of people learn they have diabetes after seeking medical care for complaints that turn out to be symptoms of ketoacidosis.
    Common Causes of Diabetic Ketoacidosis
    The three common causes of ketoacidosis are:
    Not enough insulin. This can happen if you don’t inject enough insulin or if your insulin needs increase in response to an illness such as a cold or the flu. Blood glucose can’t be used for energy without enough insulin to help in the process, so the body breaks down fat for energy and high ketone levels result.
    "Elevated blood sugars could be due to an infection or any other physical or emotional stress — good or bad," says Dr. Cohen. Unexpected increases in your blood glucose levels can increase your insulin needs. "You may have a certain amount of insulin that you usually use, but if you have an infection, you may need more insulin to help your body to improve blood sugars," Cohen explains.
    Not enough food intake. If you don’t eat enough, your body has to break down fat for energy, producing high ketone levels. This is particularly common in people who are sick and don't feel like eating.
    Low blood glucose levels. This situation can force your body to break down fat to use as energy, resulting in ketone production.
    Diabetic Ketoacidosis Symptoms
    Symptoms of ketoacidosis usually progress relatively slowly. But since diabetic ketoacidosis can be a life-threatening condition, it is important to seek medical help immediately if you experience any of its symptoms. These include:
    Excessive thirst
    Dry mouth
    Frequent urination
    Elevated blood glucose levels
    Elevated ketones in the urine
    Persistent fatigue
    Skin that is dry or flushed
    Nausea or vomiting
    Pain in your abdomen
    Shortness of breath
    A fruity smell to your breath (the result of elevated ketone levels)
    Inability to concentrate
    Confused state
    Preventing Diabetic Ketoacidosis
    Ask your endocrinologist how you can reduce your risk of developing diabetic ketoacidosis. It is often a good idea to use a home dipstick test to check for ketones in your urine when your blood glucose levels are high (over 240 milligrams per deciliter) and when you have an infection.
    Diabetes education also helps. One study found that hospital stays for ketoacidosis were reduced among a group of people who attended diabetes education classes.
    Managing Diabetic Ketoacidosis
    If think you may have ketoacidosis, it is essential to contact your doctor or get to the emergency room immediately.
    "If we can catch it early, with medicine and IV fluids, we can stop the diabetic ketoacidosis from progressing to severe dehydration," says Cohen. "Diabetic ketoacidosis, if severe and not treated aggressively, has about a 5 percent death rate, so you really want to get a handle on it rapidly."
    Remember that regularly monitoring your blood glucose levels, performing urine ketone tests as recommended, and recognizing symptoms that might indicate your ketone levels are high is the best approach to reducing your risk of diabetic ketoacidosis.
    From Everyday Health

  2. Gem93

    I recently had a friend that got DKA she only had ketones for a day and was bring violently sick she couldn't test for ketones as her strips were left at her uni campus and went home to visit her family for the weekend her mum was just about to leave to go get the strips when she said I don't feel well take me to hospital betime she got to hospital ( which is a 10 min drive from where she lives) her vains had short down and the only vain left was the one to her heart they had to cut her throat open to put in an insulin drip immediately and was put in intensive care her family was told she might not make it and that was from having ketone symptoms for just a few hours / day at the most .. This has woken me up to life alot Snd made me realise what can happen if you don't look after yourself

  3. dietcherry

    OMG Can you get her to join here so we may talk to her?

  4. -> Continue reading
read more

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