Student Name
Pre-Clinical Work
Developing Critical Thinking Through Understanding Pathophysiology
Primary problem (medical diagnosis) of patient: DIABETIC KETOACIDOSIS (DKA)
1. Define and describe in YOUR OWN WORDS, the pathophysiology of the primary problem.
Diabetic Ketoacidosis (DKA) is a serious problem that mostly happens with type 1 diabetes, but it can also occur in type 2 diabetes in some cases. It occurs when there
isn’t enough insulin in the body, which is needed for sugar (glucose) to enter the cells for energy. Because of this, blood sugar levels become very high. When the body
can’t use sugar for energy, it starts breaking down fat instead. This process creates ketones, which are acidic substances that can build up in the blood. High levels of
ketones can lead to dangerous health issues.
2. How would you explain and teach your patient about the pathophysiology of this medical problem using non-medical terminology?
Diabetic ketoacidosis (DKA) happens when your body doesn't have enough insulin, which is the hormone that helps sugar get into your cells for energy. Without enough
insulin, your body can't use sugar, so it starts breaking down fat instead. This process creates substances called ketones. When your body makes too many ketones too
quickly, they can build up and make your blood acidic, which is dangerous. This can lead to symptoms like extreme thirst, frequent urination, tiredness, and even
confusion. If DKA isn’t treated promptly, it can become very serious, so it's important to recognize the signs and get help.
3. What body system(s) are directly impacted by this disease and how are those systems affected?
Body System(s) How Body System is Affected
Endocrine System DKA happens because there’s not enough insulin. Without insulin, the body can’t use sugar for energy and starts breaking down fats,
leading to the production of ketones, which make the blood too acidic.
Renal System The kidneys have a harder time filtering out excess acids and ketones, and dehydration can lead to kidney problems.
Central Nervous System DKA affects this system by causing dehydration, electrolyte imbalances, and acidosis, which can lead to confusion, lethargy and even
coma.
Metabolic System The build-up of ketones causes a condition called metabolic acidosis, which can lead to symptoms like nausea, vomiting, and stomach
pain.
Cardiovascular System Dehydration from DKA reduces blood volume, which can lower blood pressure and affect heart rate. It can also cause imbalances in
important minerals like potassium, which are crucial for heart function.
Respiratory System Diabetic ketoacidosis (DKA) can lead to Kussmaul breathing as the body compensates for metabolic acidosis, increasing respiratory
effort. Additionally, dehydration and potential infections can further compromise respiratory function and gas exchange.
4. PRIORITY nursing assessments with this disease? (refer to body system that is most affected).
In diabetic ketoacidosis (DKA), the most affected body system is the metabolic system. A priority nursing assessment focuses on checking the patient’s blood sugar levels,
ketone levels, and hydration status. It’s important to monitor for signs of dehydration and electrolyte imbalances, as these can lead to serious complications.
, Student Name
5. What diagnostic tests are altered by this problem? How are those lab tests affected? Does the altered lab test affect any physical assessment findings? (at least two- state if
none)
Abnormal How Diagnostic Tests Affected How Does It Impact Assessments?
Diagnostic Tests
Blood electrolytes DKA often leads to changes in electrolytes, particularly The results from electrolyte tests guide the management of DKA, helping
tests sodium, potassium, and bicarbonate. Monitoring these healthcare providers decide on fluid and electrolyte replacement therapies.
levels helps assess the severity of the condition.
ECG or EKG Helps monitor and manage potential cardiac Due to electrolyte disturbances and the effects of acidosis, patients with DKA are
complications at risk for arrhythmias. The ECG can help identify these abnormalities, allowing
for timely intervention.
Chest X-ray Can be used to evaluate complications, in severe cases of A chest X-ray isn’t used to diagnose DKA directly, but it can give important
DKA, problems like fluid in the lungs (pulmonary edema) information to check for complications and help with treatment decisions.
can happen. A chest X-ray can help find these issues.
6. What lab tests are altered by this problem? How are those lab tests affected? Does the altered lab test affect any physical assessment findings? (at least four)
Abnormal How Lab Tests Affected How Does It Impact Assessments?
Lab Tests
Blood ketone test By measuring ketone levels, the test helps identify the The test helps determine if there are elevated levels of ketones, which can indicate
onset of ketosis and DKA early that the body is using fat for energy instead of glucose, a common occurrence in
uncontrolled diabetes.
Urine ketone test By measuring ketone levels, the test helps identify the The test helps determine if the body is producing excess ketones, which can
onset of ketosis and DKA early. indicate that fat is being used for energy instead of glucose. High levels of
ketones in urine can signal a risk of DKA.
Hemoglobin A1c This test will show a higher average blood sugar level A1c measures long-term glucose control, while DKA involves a rapid rise in
(HbA1c) over the past 2-3 months but might not accurately blood sugar. Factors like dehydration and changes in red blood cell lifespan can
reflect the current situation. also affect A1c results in DKA patient.
Arterial blood gas This test usually shoes metabolic acidosis, which This acidosis can lead to symptoms like confusion and rapid breathing, and it’s
(ABG) means there is too much acid in the blood due to ketone crucial for doctors to monitor these ABG results to guide treatment and correct
product. the acid-base balance.
Complete blood count This test will show elevated white blood cells counts, Monitoring CBC results helps healthcare providers assess the patient’s overall
(CBC) for leukocytes indication stress or infection, which can ne common in health and detect any complications that could be worsen the condition.
>25 patients.
Arterial pH level Reflects the severity of metabolic acidosis By using pH level testing effectively, healthcare provider can help with treatment
plans, ensure patient safety, and monitor recovery in DKA.
Pre-Clinical Work
Developing Critical Thinking Through Understanding Pathophysiology
Primary problem (medical diagnosis) of patient: DIABETIC KETOACIDOSIS (DKA)
1. Define and describe in YOUR OWN WORDS, the pathophysiology of the primary problem.
Diabetic Ketoacidosis (DKA) is a serious problem that mostly happens with type 1 diabetes, but it can also occur in type 2 diabetes in some cases. It occurs when there
isn’t enough insulin in the body, which is needed for sugar (glucose) to enter the cells for energy. Because of this, blood sugar levels become very high. When the body
can’t use sugar for energy, it starts breaking down fat instead. This process creates ketones, which are acidic substances that can build up in the blood. High levels of
ketones can lead to dangerous health issues.
2. How would you explain and teach your patient about the pathophysiology of this medical problem using non-medical terminology?
Diabetic ketoacidosis (DKA) happens when your body doesn't have enough insulin, which is the hormone that helps sugar get into your cells for energy. Without enough
insulin, your body can't use sugar, so it starts breaking down fat instead. This process creates substances called ketones. When your body makes too many ketones too
quickly, they can build up and make your blood acidic, which is dangerous. This can lead to symptoms like extreme thirst, frequent urination, tiredness, and even
confusion. If DKA isn’t treated promptly, it can become very serious, so it's important to recognize the signs and get help.
3. What body system(s) are directly impacted by this disease and how are those systems affected?
Body System(s) How Body System is Affected
Endocrine System DKA happens because there’s not enough insulin. Without insulin, the body can’t use sugar for energy and starts breaking down fats,
leading to the production of ketones, which make the blood too acidic.
Renal System The kidneys have a harder time filtering out excess acids and ketones, and dehydration can lead to kidney problems.
Central Nervous System DKA affects this system by causing dehydration, electrolyte imbalances, and acidosis, which can lead to confusion, lethargy and even
coma.
Metabolic System The build-up of ketones causes a condition called metabolic acidosis, which can lead to symptoms like nausea, vomiting, and stomach
pain.
Cardiovascular System Dehydration from DKA reduces blood volume, which can lower blood pressure and affect heart rate. It can also cause imbalances in
important minerals like potassium, which are crucial for heart function.
Respiratory System Diabetic ketoacidosis (DKA) can lead to Kussmaul breathing as the body compensates for metabolic acidosis, increasing respiratory
effort. Additionally, dehydration and potential infections can further compromise respiratory function and gas exchange.
4. PRIORITY nursing assessments with this disease? (refer to body system that is most affected).
In diabetic ketoacidosis (DKA), the most affected body system is the metabolic system. A priority nursing assessment focuses on checking the patient’s blood sugar levels,
ketone levels, and hydration status. It’s important to monitor for signs of dehydration and electrolyte imbalances, as these can lead to serious complications.
, Student Name
5. What diagnostic tests are altered by this problem? How are those lab tests affected? Does the altered lab test affect any physical assessment findings? (at least two- state if
none)
Abnormal How Diagnostic Tests Affected How Does It Impact Assessments?
Diagnostic Tests
Blood electrolytes DKA often leads to changes in electrolytes, particularly The results from electrolyte tests guide the management of DKA, helping
tests sodium, potassium, and bicarbonate. Monitoring these healthcare providers decide on fluid and electrolyte replacement therapies.
levels helps assess the severity of the condition.
ECG or EKG Helps monitor and manage potential cardiac Due to electrolyte disturbances and the effects of acidosis, patients with DKA are
complications at risk for arrhythmias. The ECG can help identify these abnormalities, allowing
for timely intervention.
Chest X-ray Can be used to evaluate complications, in severe cases of A chest X-ray isn’t used to diagnose DKA directly, but it can give important
DKA, problems like fluid in the lungs (pulmonary edema) information to check for complications and help with treatment decisions.
can happen. A chest X-ray can help find these issues.
6. What lab tests are altered by this problem? How are those lab tests affected? Does the altered lab test affect any physical assessment findings? (at least four)
Abnormal How Lab Tests Affected How Does It Impact Assessments?
Lab Tests
Blood ketone test By measuring ketone levels, the test helps identify the The test helps determine if there are elevated levels of ketones, which can indicate
onset of ketosis and DKA early that the body is using fat for energy instead of glucose, a common occurrence in
uncontrolled diabetes.
Urine ketone test By measuring ketone levels, the test helps identify the The test helps determine if the body is producing excess ketones, which can
onset of ketosis and DKA early. indicate that fat is being used for energy instead of glucose. High levels of
ketones in urine can signal a risk of DKA.
Hemoglobin A1c This test will show a higher average blood sugar level A1c measures long-term glucose control, while DKA involves a rapid rise in
(HbA1c) over the past 2-3 months but might not accurately blood sugar. Factors like dehydration and changes in red blood cell lifespan can
reflect the current situation. also affect A1c results in DKA patient.
Arterial blood gas This test usually shoes metabolic acidosis, which This acidosis can lead to symptoms like confusion and rapid breathing, and it’s
(ABG) means there is too much acid in the blood due to ketone crucial for doctors to monitor these ABG results to guide treatment and correct
product. the acid-base balance.
Complete blood count This test will show elevated white blood cells counts, Monitoring CBC results helps healthcare providers assess the patient’s overall
(CBC) for leukocytes indication stress or infection, which can ne common in health and detect any complications that could be worsen the condition.
>25 patients.
Arterial pH level Reflects the severity of metabolic acidosis By using pH level testing effectively, healthcare provider can help with treatment
plans, ensure patient safety, and monitor recovery in DKA.
