Dka

Front 1

What symptoms of a patient may precede DKA?

Back 1

Fatigue & Polyuria

Front 2

If a patient does not have Diabetes, what can cause DKA?

Back 2

Alcoholism, Acute Pancreatitis, and Starvation (Annorexia)

Front 3

What is the range of blood glucose in a patient experiencing DKA?

Back 3

250-800

Front 4

If a patient is experiencing DKA, what serum levels will be elevated that indicate a complication of Type I diabetes?

Back 4

Amylase & Lipase

Front 5

What are the 2 main indicators of DKA?

Back 5

Presence of Ketones in the urine, and elevated Blood glucose (250-800 mg/dl)
Note: presence of ketones in the urine are due to the metabolism of free fatty acids into ketones.

Front 6

What are the main symptoms of DKA?

Back 6

Dehydration, polyuria, glycosuria, ketoacidosis, acid-base imbalance (<7.3).

Front 7

What are some of the main clinical manifestations of DKA?

Back 7

Dehydration, extreme fatigue, CNS depression, lethargy, change in LOC that can lead to Coma, tinting skin turgor, sunken eyeballs, kussmals respirations, FRUITY BREATH, tachycardia, hypotension.

Front 8

What are the goals when treating DKA?

Back 8

Reverse dehydration (NS), replace insulin (IV drip), reverse ketoacidosis (bicarbonate if pH < 7.0), replenish e-lytes (K-replacement).

Front 9

What is important to remember when caring for a newly diagnosed type I diabetic?

Back 9

Newly diagnosed type 1 diabetics take longer to clear their ketones from their urine, and they require more insulin to achieve normal glucose control.

Front 10

What is the main indicator that DKA has subsided?

Back 10

Normal pH. DO NOT discontinue insulin drip until ketoacidosis subsides!

Front 11

Due to dehydration secondary to DKA, what important problem can occur with the heart?

Back 11

Decreased CO r/t alterations in preload.

Front 12

What do you want to assess in a patient receiving care that is attempting to correct DKA? (4 things)

Back 12

Hourly urine output, V/S (HR is thready initially then strong and full once BP is normalized), CVP (normal = adequate fluid replacement), Respirations (check for presence of fruity acetone odor).

Front 13

Which lab studies may be elevated in the presence of DKA? (3 things)

Back 13

Anion gap (>20 mEq/L; indicative of e-lyte imbalance), BUN, Serum Osmolality (>300)

Front 14

Which lab studies my be low in the presence of DKA? (3 things)

Back 14

CO2 Venous sample (d/t uncompensated metabolic acidosis); Serum Na+; Serum K+ (indicates severe total body potassium deficiency).

Front 15

What complications should you watch for while correcting DKA? (6 things)

Back 15

Fluid volume overload; hypoglycemia; K+ level; Hyponatremia; Risk for cerebral edema; Risk for infection.

Front 16

What is the highest safe amount of K+ to give to a patient in an hour?

Back 16

20 mEq/hr

Front 17

In DKA, does your HR increase or decrease with hyperkalemia, and what should you have near by if hyperkalemia is suspected?

Back 17

HR decreases; you nee a crash cart with Atropin, Defibrillator, and a pace maker.

Front 18

What is the first sign of hyponatremia and how do you treat it?

Back 18

Change in LOC is the first sign; Treat it with 0.9% normal saline.

Front 19

How is Sodium lost from the body?

Back 19

Sweating (diaphoresis), urine (polyuria), vomiting

Front 20

What is the main precaution a nurse should take when caring for a patient with DKA?

Back 20

Seizure precautions

Front 21

What are some of the main interventions to prevent infection in the patient with DKA?

Back 21

Frequent repositioning; Oral care (suction or have pt. spit after mouth care); Sterile technique; Catheter care q8h;