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Understanding Diabetic Ketoacidosis (DKA)
Jan 15, 2025
Lecture on Diabetic Ketoacidosis (DKA)
Introduction
Speaker
: Sarah from RegisteredNurseAriene.com
Topic
: Diabetic Ketoacidosis (DKA)
Part of an endocrine series on diabetes.
Additional content on Hyperglycemic Hyperosmolar Non-Ketotic Syndrome (HHNS) and comparison with DKA to follow.
Encourages visiting website for a quiz on DKA.
Definition of DKA
DKA
: A life-threatening condition mostly in diabetic patients due to lack of insulin.
Insulin is crucial for glucose utilization by cells.
Absence of insulin leads to fat breakdown, releasing ketones.
Key Components
: Hyperglycemia, Ketosis, Acidosis.
Pathophysiology
Glucose
: Essential for cellular energy but remains in blood due to lack of insulin.
Blood sugar > 300 mg/dL.
Insulin
: Absent in DKA, prevents glucose from entering cells.
Liver & Glucagon
: Misunderstand body signals, increase blood glucose by releasing glycogen.
Breakdown of Fats
: Leads to ketone production, causing blood acidity.
Kidneys
: Fail to reabsorb glucose, leading to osmotic diuresis and electrolyte imbalance.
Typical Patient Profile
Occurs mostly in Type 1 diabetics, rarely in Type 2 diabetics unless during severe illness.
Causes of DKA
Undetected Diabetes
: Initial symptom in undiagnosed diabetics.
Increased Insulin Demand
: Illness, stress, corticosteroids, or thiazide diuretics.
Skipping Meals
: Leads to starvation mode, fat breakdown into ketones.
Non-compliance with Insulin
: Lack of understanding or adherence results in high glucose levels.
Signs and Symptoms
Hyperglycemia
: High blood glucose, cellular dehydration, electrolyte shifts.
Ketones in Blood
: Weight loss, metabolic acidosis, fruity breath.
Acidosis
: pH < 7.35, low bicarbonate, Kussmaul breathing.
Sudden Onset
: Unlike gradual HHNS onset.
Polyuria
: Due to osmotic diuresis.
Polydipsia and Dehydration
: Excessive thirst and fluid loss.
Nausea/Vomiting/Abdominal Pain
: Especially in pediatric patients.
Tachycardia and Hypotension
: Due to dehydration.
Fatigue and Confusion
.
Nursing Interventions
Education
:
Monitor glucose and urine ketones every 4 hours when sick.
Notify doctor if unable to eat/drink, have high glucose, or ketones.
Pharmacological Goals
:
Hydration, blood sugar reduction, potassium level monitoring, acid-base correction.
Medication Management
IV Fluids
: Begin with isotonic saline, possibly switch to hypotonic solutions.
Insulin Administration
:
Only regular insulin IV.
Check potassium levels (>3.3) before administration.
Insulin drip titrated based on glucose readings.
Monitor for hypokalemia.
Potassium Monitoring
:
Monitor ECG and renal function.
Conclusion
Encourages taking the DKA quiz on the website.
Upcoming video on HHNS.
Call to subscribe to YouTube channel.
📄
Full transcript