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Diabetic Ketoacidosis (Concept: Metabolism). - Coggle Diagram
Diabetic Ketoacidosis (Concept: Metabolism).
What is DKA?
Hyperglycemia resulting in the breakdown of fat and muscle in the body, resulting in extra ketones in the blood, leading to acidosis.
Affects mainly those with Type 1 diabetes
Usually seen in younger patients unaware of their diabetes or that are overworked.
Usually happens suddenly
How do we know when it's DKA?
Lab testing
BG testing >300 mg/dL
Presence of ketones in the blood.
pH testing for acidosis, <7.35.
Pathophysiology
Absence of insulin in the body results in glucose molecules moving into the bloodstream, where they are unable to be used.
As a result of this, the body has to get energy from other sources, usually being fat or muscle. With the breakdown of fat or muscle in the body, ketones are released into the bloodstream as well, which results in metabolic acidosis.
What does DKA look like?
Delirium
Kussmaul Respirations
Abdominal problems (nausea, pain, vomiting)
Dehydration
Headache
Blurred vision
Fatigue, weakness
Fruity breath
What general focused assessments can we do to determine if it is DKA?
Neurological assessments
Fluid volume assessments
Sweating, peeing, dizzy upon standing.
Polyuria, polydipsia, vomiting.
Hemodynamic assessments
Orthostatic hypotension, hypotension, weak and rapid pulse.
Safety assessments
How can we fix/manage DKA?
Stable BG levels
Dependent on patient's baseline BG levels.
Administer insulin to stabilize BG levels.
Stable hemodynamic status
Stable electrolytes
Watch K+ carefully when giving insulin, make sure level is at least 3.3 before administering.
Stable fluid volume
Administer fluids carefully, doing so too quickly could lead to cerebral edema.
Targeted Interventions
Treat hyperglycemia - insulin infusion
Rehydration
Electrolyte replacement
Reversing acidosis
What can cause DKA?
No insulin in the body (remember Type 1 diabetes).
Insulin has either been skipped, or one is unaware of their diagnosis.
Can also occur as a result of injury ot illness because of the body's sympathetic response.
Usually occurs in young or undiagnosed diabetics.