Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)

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