Dka 2024 Latest Questions With Graded A+ Solutions!!

Before giving IV potassium - -make sure the patient produces at least 30 mL/hr of urine. Cardiovascular Assessment - Orthostatic hypotension Classic symptoms of DKA - polyuria, polydipsia, polyphagia, weight loss, vomiting, abdominal pain, dehydration, weakness, altered mental status, shock, and coma. Deficient knowledge - Lots of ed Diabetic Ketoacidosis (DKA) - total or partial lack of insulin DKA Outcomes - -patient is expected to have few episodes of hyperglycemia and avoid diabetic ketoacidosis •Maintains blood glucose levels within the target range •Adjusts insulin doses to match eating patterns and blood glucose levels during illness •Describes correct procedure for urine ketone testing •Describes when to seek help from health care professional DKA - decrease insulin, break down of fat DKA ED check blood glucose levels every 4 to 6 hours as long as - symptoms such as anorexia, nausea, and vomiting are present and as long as glucose levels exceed 250 mg/dL (13.8 mmol/L) DKA ED check urine ketone levels when - blood glucose levels exceed 300 mg/dL (16.7 mmol/L).DKA ED consult the primary care provider when - •Blood glucose exceeds 250 mg/dL (13.8 mmol/L). •Ketonuria lasts for more than 24 hours. •The patient cannot take food or fluids. •Illness lasts more than 1 to 2 days. DKA ED drink at least - 3 L of fluid daily and increase if infection DKA ED Sick days Call your primary care provider for any of these danger signals - •Persistent nausea and vomiting •Moderate or large ketones •Blood glucose elevation after two supplemental doses of insulin •High (101.5° F [38.6° C]) temperature or increasing fever; fever for more than 24 hours •Treat symptoms (e.g., diarrhea, nausea, vomiting, fever) as directed by your primary care provider. •Get plenty of rest. DKA Interventions Acidosis Management Bicarbonate - -used only for severe acidosis because it may reverse acidosis too rapidly and lead to severe hypokalemia, which can cause fatal cardiac dysrhythmias -given by slow IV infusion over several hours when the arterial pH is 7.0 or less or the serum bicarbonate level is less than 5 mEq/L (5 mmol/L). DKA Interventions Acidosis Management - -insulin therapy serum potassium levels fall rapidly as potassium shifts into the cells -Assess for signs of hypokalemia-ECG DKA Interventions Drug Therapy - insulin lower serum glucose by about 75 to 150 mg/dL/hr -initial IV bolus dose of 0.1 unit/kg -followed by an IV drip of 0.1 unit/kg/hr. -Subcutaneous insulin is started when the patient can take oral fluids and ketosis has stopped -hourly blood glucose measurements DKA Interventions Fluid and Electrolyte Management 1st goal - -restore volume and maintain perfusion to the brain, heart, and kidneys. -Infuse 1 L of isotonic saline over 30 to 60 minutes. -a second liter is given in the next hour DKA Interventions Fluid and Electrolyte Management