What is the first step in DKA management?
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 is the two bag method DKA?
Background: The “two-bag method” of management of diabetic ketoacidosis (DKA) allows for titration of dextrose delivery by adjusting the infusions of two i.v. fluid bags of varying dextrose concentrations while keeping fluid, electrolyte, and insulin infusion rates constant.
Why is potassium given in DKA?
Replacement of potassium in intravenous fluids is the standard of care in treatment of DKA to prevent the potential consequences of hypokalemia including cardiac arrhythmias and respiratory failure.
Which insulin is used for diabetic ketoacidosis?
Insulin lispro (Humalog)
How do you calculate fluid deficit in DKA?
- Maintenance fluids are calculated using the standard (Holliday-Segar) formula:
- General Principles:
- ALWAYS recheck the fluid calculation; errors occur frequently.
- Total hourly fluid rate =
- Total Deficit / 48 in mL + calculated hourly maintenance in mL.
Why is urine checked for ketones in a DKA patient?
The urine test for ketones is performed using test strips. There are several reasons why a ketone test may be needed: It is a convenient way to monitor diabetes in addition to monitoring blood sugar (glucose) levels, especially when the glucose levels are high and there is a risk of DKA.
What is the nursing priority for DKA?
After initial stabilization of circulation, airway, and breathing as a priority, specific treatment of DKA requires correction of hyperglycemia with intravenous insulin, frequent monitoring, and replacement of electrolytes, mainly potassium, correction of hypovolemia with intravenous fluids, and correction of acidosis.
What should I monitor in DKA?
Patients should be monitored closely and frequently. Blood glucose should be evaluated every one to two hours until the patient is stable, and the blood urea nitrogen, serum creatinine, sodium, potassium, and bicarbonate levels should be monitored every two to six hours depending on the severity of DKA.
How to manage DKA?
Management. Children and adolescents with DKA should be managed in a unit that has: Access to laboratory services for frequent and timely evaluation of biochemical variables; Experienced nursing staff trained in monitoring and management of DKA in children and adolescents
How to determine DKA?
Cerebral oedema is the key life-threatening complication of DKA
What happens If DKA is not treated?
One of the ketone bodies formed (acetone) leaves the body via the lungs, giving the breath of the person with DKA a characteristic, fruity smell. This is how DKA can be detected. DKA can induce coma or even death if not treated immediately. Signs & symptoms of DKA:
What does DKA mean?
high blood sugar levels