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S.C 29 yo male (Diabetic Ketoacidosis: …
S.C 29 yo male
Diabetic Ketoacidosis: Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs when insulin deficiency inhibits the ability of glucose to enter cells for fuel, the result being that the liver rapidly breaks down fat into ketones to use as a fuel source. The overproduction of ketones ensues, causing them to accumulate in the blood and urine and turn the blood acidic.
Monitor lab values and urine for ketones, anion gap, ABGs, H&H for signs of DKA
Decreased sodium levels
Increased potassium levels due to insulin not "pushing K into cell
SEE decreased sodium
Increased BUN and Creat values indicative of AKI
Restrict access to free water to decrease urination frequency. Continue to treat DKA.
Elevated glucose levels
Increased d/t lack of insulin to regulate BG. Supply pt with insulin drip and continuous fluid and continue to monitor.
Acidosis
Supply pt with insulin drip and fluids. This will help glucose metabolism and decreased ketones. Encourage pt to take deep breaths, and continue to monitor
D/t decreased venous volume of water and rapid urination. Supply pt with slow rate of hypertonic or isotonic fluids for long periods of time. Monitor values, monitor I&O, restrict free water access
Type 1 Diabetes Mellitus This happens when there is damage to pancreatic beta cells resulting in low secretion of insulin. This results in an inability to regulate blood glucose levels without supplemental insulin.
High blood glucose levels if not regulated
Fatigue, weakness
Increased thirst and hunger
Weight loss
Impaired wound healing
Teach pt about diabetic neuropathy, teach how to complete through skin assessments
Monitor diet, teach pt about counting carbohydrates
Educate pt on exercise and diet needs for diabetic management
Educate pt on monitoring blood glucose levels, and proper insulin therapy
Further education on recognizing the s/s of DKA- urine dip, fruity breath, fatigue weakness, increased urination, increased thirst, abdominal pain, rapid breathing, confusion, overall malice
Tell the pt to see a provider IMMEDIATELY if symptoms occur