Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)

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Outline

Diabetic Ketoacidosis

 

Definition/Etiology:

  • Blood sugar abnormally high resulting from 
    • Infection
    • Not taking meds

 

Pathophysiology:

  • Body doesn’t have enough insulin
  • Build up of acid in blood

 

Noticing: Assessment & Recognizing Cues:

  • Polyuria, Polydipsia
  • Fruity-breath
  • AMS
  • Vomiting/ Abd pain
  • Fatigue
  • SOB

 

Interpreting: Analyzing & Planning:

  • Blood glucose
  • Hemoglobin A1c
  • Anion gap (>10 mEq/L)
  • ABG (acidosis)
  • Urinalysis (ketones)
  • BMP so we can manage electrolytes

 

Responding: Patient Interventions & Taking Action:

  • Insulin drip, typically there is a protocol in place, PLUS only regular insulin can be administered IV
  • IVF
  • Electrolyte replacement

 

Reflecting: Evaluating Patient Outcomes:

  • Blood glucose level improves (baseline)
  • Prevention/management

 

Linchpins (Key Points):

  • F.I.G.H.T Ketones
  • Fruit-breath
  • IV Insulin/fluids
  • Gap
  • Hyperglycemia
  • Tired/ out of it
  • Ketones

 

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References

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