What is diabetic ketoacidosis guidelines?
Criteria for resolution of DKA includes a glucose <200 mg/dl, serum bicarbonate ≥18 mEq/l, and a venous pH of >7.3. Once DKA is resolved, if the patient is NPO, continue intravenous insulin and fluid replacement and supplement with subcutaneous regular insulin as needed every 4 h.
What IV fluids are given for DKA?
Normal saline (0.9% sodium chloride) is the most commonly used intravenous fluid in treating DKA, but it has a very high concentration of chloride and can lead to additional acid production when given in large volumes.
What are the basic principles of DKA management?
The basic principles of DKA management include rapid restoration of adequate circulation and perfusion with isotonic intravenous fluids, gradual rehydration and restoration of depleted electrolytes, insulin to reverse ketosis and hyperglycaemia and regular monitoring of clinical signs and laboratory tests to detect and …
Which insulin is used for diabetic ketoacidosis?
Only short-acting insulin is used for correction of hyperglycemia in DKA. The optimal rate of glucose decline is 100 mg/dL/h. The blood glucose level should not be allowed to fall lower than 200 mg/dL during the first 4-5 hours of treatment.
What ketone level is DKA?
Blood ketone meter measurements (BHB) with a meter:
|Normal||Less than 0.6 mmol/L|
|Medium (ketosis)*||Between 0.6 and 1.5 mmol/L|
|High*||Between 1.5 and 3.0 mmol/L|
|Possible DKA**||Greater than 3.0 mmol/L|
What is the treatment for diabetic ketoacidosis?
Diabetic ketoacidosis is treated with fluids, electrolytes — such as sodium, potassium and chloride — and insulin. Perhaps surprisingly, the most common complications of diabetic ketoacidosis are related to this lifesaving treatment.
Is LR or NS better for DKA?
Normal saline induces a hyperchloremic acidosis which drops bicarbonate levels in the initial phase of DKA resuscitation, and is probably not the ideal fluid to use. LR, Plasmalyte, or Normosol are better choices.
What kind of fluid replacement be indicated for a patient with DKA?
The initial priority in the treatment of diabetic ketoacidosis is the restoration of extra-cellular fluid volume through the intravenous administration of a normal saline (0.9 percent sodium chloride) solution.
What are the goals of nursing management of the patient with diabetic ketoacidosis?
- Monitor vitals.
- Check blood sugars and treat with insulin as ordered.
- Start two large-bore IVs.
- Administer fluids as recommended.
- Check electrolytes as potassium levels will drop with insulin treatment.
- Check renal function.
- Assess mental status.
- Look for signs of infection (a common cause of DKA)
How do you manage DKA in ICU?
TREATMENT OPTIONS IN THE ED OR ICU The treatment of acute DKA includes restoration of fluid deficits in the first 24 to 36 h, electrolyte replacement and insulin therapy, which is administered slowly to decreased plasma glucose[23,24].
Why is regular insulin used for diabetic ketoacidosis?
Insulin administration is essential in DKA treatment because it promotes glucose utilization by peripheral tissues, diminishes glycogenolysis and gluconeogenesis, and suppresses ketogenesis. Intravenous infusion is a preferred route of insulin delivery in patients with DKA.
How do you check for diabetic ketoacidosis?
Upon arrival at the hospital, a doctor may perform a variety of tests to determine whether you’re suffering from diabetic ketoacidosis or another condition. These include a blood sugar test, a blood test of electrolytes and kidney function, and a blood test to look for acid in the blood.
How does DKA kill you?
With Diabetic Ketoacidosis (DKA) your blood becomes highly acidic from dehydration and excessive ketone production; it can kill you. Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production.
What labs indicate DKA?
DKA occurs mainly in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. Laboratory studies for DKA include glucose blood tests, serum electrolyte determinations, blood urea nitrogen (BUN) evaluation, and arterial blood gas (ABG) measurements.
Why is diabetic ketoacidosis so dangerous?
Diabetic Ketoacidosis. Diabetic Ketoacidosis is a very dangerous condition that can occur when patients neglect to take their insulin and have uncontrolled blood sugar. Since insulin is necessary to break down glucose as a source of energy, the body then turns to body fat as a fuel source.