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32 Cards in this Set
- Front
- Back
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Triad of DKA
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Uncontrolled Hyperglycemia
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Triad of DKA
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Ketosis
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Triad of DKA
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Metabolic Acidosis
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Successful Management of DKA
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Correct for:
1) Dehydration 2) Hyperglycemia 3) Electrolyte imbalances |
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1st Line Treatment of DKA
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Fluids!
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Bolus Dose of Fluids
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15 - 20 mL / kg 0.9% NaCl
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What do you do when glucose decreases to less than 200 mg/dL?
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Add dextrose to the IVF
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What is the insulin treatment of choice?
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Continuous infusion
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Continuous Infusion rate of insulin for DKA?
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0.1 unit / kg / hr
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Bolus insulin dose for DKA?
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0.1 unit/ kg
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How much should plasma glucose decrease per hour?
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~50 to 75 mg/dL
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What should you change the infusion rate after glucose decreases to less than 200 mg/dL?
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0.02 to 0.5 units / kg / hr
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When is DKA resolved?
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- blood gluocose < 200 mg/dL
- ketoacidosis resolved - patient able to tolerate PO |
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How long should continuous infusion be continued after the SQ insulin is give?
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1 to 2 hours
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Complication of DKA
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hypoglycemia, hypokalemia
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Complication of DKA
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Hyperglycemia
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Complication of DKA
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Cerebral edema
**Patient usually has headache |
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What do you treat cerebral edema with?
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Mannitol
0.5 - 1.0 gram / kg / 20 minutes 3% Hypertonic Saline (5-10 mL/kg / 30 minutes |
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HHS stands for?
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hyperglycemic hyperosmolar state
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Does HHS have ketones?
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NO
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What type of diabetes do these patients have?
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Type 2
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Management of HHS
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1) Fluid replacement
2) Insulin administration |
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When should dextrose be added in HHS?
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Blood glucose less than 300 mg/dL
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Criteria for HHS ... glucose?
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> 600
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Criteria for HHS ... arterial pH?
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>7.3
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Criteria for HHS .... ketones?
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small to none
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Criteria for HHS ... Osmality?
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>320
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Criteria for HHS....anion gap?
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<12
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Inpatient glycemic control for HHS?
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140 - 180 mg/dL
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Why is less than 110 mg/dL not recommended in critically ill patients?
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Increased mortality in 90 days after intensive glucose control
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What is pre-prandial target for blood glucose?
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< 140 mg/dL
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What should a random BG be?
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<180 mg/dL
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