Diabetic Ketoacidosis:
Contents:
1.
Definition of Diabetic Ketoacidosis.
2.
Causes of Diabetic Ketoacidosis.
3.
Signs & symptoms of Diabetic
Ketoacidosis.
4.
Risk factors of Diabetic Ketoacidosis.
5.
Diagnosis of Diabetic Ketoacidosis.
6.
Medical Management of Diabetic Ketoacidosis.
7.
Nursing Management of Diabetic
Ketoacidosis.
8.
Prevention of Diabetic Ketoacidosis.
9.
Complication of Diabetic Ketoacidosis.
Definition of Diabetic
Ketoacidosis:
Diabetic Ketoacidosis
is an extreme metabolic state caused by insulin deficiency. It is defined as an
acute state of severe uncontrolled diabetes associated with Ketoacidosis that
requires emergency treatment.
Causes of Diabetic Ketoacidosis:
1. An illness where
the body produces higher levels of stress hormones.
2. Not sufficient
insulin due to missed doses or more requirements.
3. Alcohol or drug
abuse.
4. Less food intake
caused by sickness, fasting, or eating disorders.
5. Medications like
corticosteroids and diuretics.
6. Pregnancy.
7. Heart attack.
Signs & symptoms of Diabetic
Ketoacidosis:
Signs
of DKA include:
1. Needing to pee
more than usual.
2. Feeling very
thirsty.
3. Being sick.
4. Tummy pain.
5. Breath that smells
fruity.
6. Deep or fast breathing.
7. Feeling very tired
or sleepy.
8. Confusion.
9. Passing out.
Risk Factors of Diabetic
Ketoacidosis:
1. Have type 1
diabetes.
2. Are under the age
of 19.
3. Have had some form
of trauma, either emotional or physical.
4. Are stressed.
5. Have a high fever.
6. Have had a heart
attack or stroke.
7. Smoke.
8. Have a drug or
alcohol addiction.
Diagnosis of Diabetic
Ketoacidosis:
1. Glucose
levels in the blood (can be measured at the spot
using a device known as a glucometer).
2. Ketones
levels in blood or urine (Ketones levels in urine
can be measured using some special strips).
3. Blood
PH (a
test which measures a number of acids in the blood) and Pco2 (a test which
measures the amount of carbon dioxide in the blood).
4. Serum
HCO3 (a
substance that neutralizes acids in the body).
5. Serum
electrolytes (a test which measures a number
of certain chemicals like sodium, chloride, potassium in the blood).
6. Serum
Creatinine and urea (a test which is used to see if
kidneys are functioning properly or not because diabetic ketoacidosis could
affect a patient’s kidneys).
Medical Management of Diabetic
Ketoacidosis:
1.
Fluid replacement.
Receive fluids — either by mouth or through a vein— until rehydrated. The
fluids will replace those lost through excessive urination, as well as help
dilute the excess sugar in blood.
2.
Electrolyte replacement. Electrolytes
are minerals in blood that carry an electric charge, such as sodium, potassium
and chloride. The absence of insulin can lower the level of several electrolytes
in blood. Receive electrolytes through a
vein to help keep heart, muscles and nerve cells functioning normally.
3.
Insulin therapy. Insulin
reverses the processes that cause diabetic ketoacidosis. In addition to fluids
and electrolytes, receive insulin therapy — usually through a vein. When blood
sugar level falls to about 200 mg/dL (11.1 mmol/L) and blood is no longer
acidic, may be able to stop intravenous insulin therapy and resume normal
subcutaneous insulin therapy.
Nursing Management of Diabetic
Ketoacidosis:
1. Monitor blood
glucose levels and administer insulin as appropriate.
2. Monitor for and
treat signs / symptoms of infection.
3. Administer
medications as appropriate Insulin as necessary.
a) Antibiotics.
b) IV
fluids.
c) Electrolyte
replacement.
d) Antiemetics.
4. Monitor vitals for
signs / symptoms of hypovolemia.
5. Nutrition and
lifestyle education for fluid and electrolyte balance to prevent dehydration.
Prevention of Diabetic
Ketoacidosis:
1. Take diabetes
medication as directed.
2. Follow meal plan
and stay hydrated with water.
3. Test blood sugar
consistently.
4. Set an alarm if
take it at the same time every day.
5. Pre-fill syringe
or syringes in the morning.
6. Talk to doctor
about adjusting insulin dosage levels.
7. Test urine for
ketone levels during periods of high stress or illness.
Complication of Diabetic
Ketoacidosis:
DKA
can cause complications such as:
1. Low levels of potassium (hypokalemia).
2. Swelling inside the brain (cerebral edema).
3. The fluid inside lungs (pulmonary edema).
4. Damage to kidney or other organs from
fluid loss.
Diabetic Ketoacidosis
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