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Why Do You Vomit In Dka?

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Understanding The Presentation Of Diabetic Ketoacidosis

Hypoglycemia, diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) must be considered while forming a differential diagnosis when assessing and managing a patient with an altered mental status. This is especially true if the patient has a history of diabetes mellitus (DM). However, be aware that the onset of DKA or HHNS may be the first sign of DM in a patient with no known history. Thus, it is imperative to obtain a blood glucose reading on any patient with an altered mental status, especially if the patient appears to be dehydrated, regardless of a positive or negative history of DM. In addition to the blood glucose reading, the history — particularly onset — and physical assessment findings will contribute to the formulation of a differential diagnosis and the appropriate emergency management of the patient. Pathophysiology of DKA The patient experiencing DKA presents significantly different from one who is hypoglycemic. This is due to the variation in the pathology of the condition. Like hypoglycemia, by understanding the basic pathophysiology of DKA, there is no need to memorize signs and symptoms in order to recognize and differentiate bet Continue reading >>

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  1. AMZMD

    The human body is in a constant process of maintaining equilibrium. The byproducts of burning fat for energy (ketones) are deposited in the blood for excretion. As the ketones build up in your system, the pH of your blood drops and you become acidotic. As stated above, your body is trying to maintain equilibrium, so it will do certain things to eliminate as much acid from your system as possible, as quickly as possible. One way is to vomit, which dumps huge amounts of H+ instantly. Other reactions are increased respirations to eliminate CO2, as well as dumping the ketones and H+ out through your urine.
    As a side note, the dumping of H+ through urine causes the retention of potassium and you become hyperkalemic (aka "too-much-potassium-emia"). This inhibits myocardial function and can put you into cardiac arrest. This is why extreme no-carb diets are a very bad thing!
    Hope that helps!

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