Signs & Symptoms
Potential pulmonary symptoms of a pt in DKA.
What are kussmaul respirations (deep, rapid, labored breathing) and fruity breath (acetone production)?
Normal fasting blood glucose range in mg/dL.
What is 70-99 mg/dL?
This is the top priority intervention for a patient in DKA.
DKA results from a severe deficiency of this hormone.
What is insulin?
Proper nursing intervention if your BG drops below 70.
What is follow hypoglycemia protocol/order set?
Potential gastrointestinal symptoms for a pt in DKA.
What is nausea, vomiting, abd pain, & wt loss?
This lab value is elevated in DKA due to fat breakdown.
What are ketones or serum ketones?
This hormone is administered via IV to lower blood glucose in DKA.
What is insulin?
Without insulin, the body breaks down this macronutrient for energy, leading to ketone production.
What is fat (lipids)?
The RN should do what if BG is < 200 AND Anion Gap is LESS than OR equal to 12.
What is notify the provider?
Potential neurological symptoms experienced for a patient in DKA?
What is altered mental status, headache, or confusion?
This arterial blood gas value is decreased due to metabolic acidosis in DKA.
What is pH?
This electrolyte must be monitored closely and often replaced, especially before giving insulin.
What is potassium?
Clinical manifestations of DKA are: _____(hyper/hypo)glycemia, ____(hyper/hypo)osmolarity, and anion gap _____(acidosis/alkolosis)
What is hyperglycemia, hyperosmolarity, and anion gap acidosis?
*hyperglycemia=High BG
*Hyperosmolarity=a condition where the blood or other bodily fluids have an abnormally high concentration of salt, glucose, and other substances. (Think dehydration)
*Anion gap acidosis=a type of metabolic acidosis where the blood becomes too acidic due to a build-up of unmeasured anions, resulting in a larger than normal "anion gap" which is calculated by subtracting the measured negative ions (chloride and bicarbonate) from the measured positive ions (sodium) in the blood; essentially indicating an imbalance between positively and negatively charged electrolytes in the bloodstream.
Dextrose containing fluids should be started at what point.
What is when BG is < 250?
Follow provider orders
Potential cardiovascular symptoms for a pt in DKA.
What is tachycardia, decreased CVP, decreased BP?
Blood glucose level typically greater than this in DKA diagnosis.
What is 250 mg/dL?
How frequently should patients get their blood sugar checked while on an insulin gtt?
What is at least every hour?
Unlike DKA, this hyperglycemic condition usually occurs in type 2 diabetics and involves minimal ketone production.
What is HHS (Hyperosmolar Hyperglycemic State)?
Insulin Infusion orderset's main characteristics/focus.
What is titrating insulin gtt based off the patients blood glucose?
This trio of symptoms ____, _____, _____ is classic for uncontrolled diabetes.
What are polyuria, polydipsia, and polyphagia?
How does insulin lower K+?
What is insulin helps facilitate the transfer of glucose and K+ from the extracellular fluid back into the intracellular fluid, therefore resulting in a lower serum potassium level?
How should you prime your tubing when starting insulin?
What is waste 20mL?
Glucose sucks water into blood stream and out into urine with it. This process is called ___ ____, leading to severe dehydration and fluid loss in DKA.
What is osmotic diuresis?
DKA orderset's main characteristic/focus.
What is fluid resuscitation?
Generally speaking, insulin will have a more consistent rate and you will be titrating fluids depending on BG. ALWAYS FOLLOW ORDERS