Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Included In This Lesson
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
Transcript
References
- Lu, J., Zello, G. A., Randell, E., Adeli, K., Krahn, J., & Meng, Q. H. (2011). Closing the anion gap: Contribution of D-lactat to diabetic ketoacidosis. Clinica Chimica Acta, 412(3-4), 286-291.
- Mayo Clinic. (2022a). Diagnosis & treatment. Diabetic ketoacidosis. https://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/diagnosis-treatment/drc-20371555.
- Mayo Clinic. (2022b). Symptoms & causes. Diabetic ketoacidosis. https://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/symptoms-causes/syc-20371551.