Sodium is corrected in hyperglycemia by ___ mEq for every ____ mg/dL of glucose.
1.6 for every 100
100
How often should serum glucose be measured initially in a patient with DKA or HHS?
Every hour
100
Initial insulin therapy of choice in patients with moderate to severe DKA or HHS is:
a. SQ rapid-acting
b. IV regular
c. SQ long-acting
b
100
What is the first step in treating a patient with DKA or HHS?
Infusion of isotonic saline
200
In which of the two conditions do we most often find serum glucose concentrations exceeding 1000mg/dL?
What is HHS?
200
Insulin drives potassium ____ the cells and will _____ hypokalemia in patients with DKA.
into;worsen
200
Name the most common complication of treatment for DKA and HHS?
Hypoglycemia
200
What is the only indication for delaying insulin therapy in a patient with moderate to severe DKA or HHS?
A serum K+ level below 3.3 mEq/L
200
In hypovolemic patients without shock or heart failure, at what rate should isotonic saline initially be infused?
15-20mL/kg/hr
300
What percent of patients with DKA and HHS will have an overlap between the two conditions?
What is more than 33% (1/3) of patients?
300
When should K+ replacement be initiated in a DKA or HHS patient with an initial serum K+ > 5.3 mEq/L?
When the K+ level falls below 5.3 mEq/L
300
When is it appropriate to add dextrose to saline IV fluids in a patient with HHS?
When serum glucose reaches 250-300mg/dL
300
IV regular insulin is (more, less, or equally) effective when compared to IV glulisine insulin in the treatment of DKA. IV insulin is preferred due to ____ considerations.
equally;cost
300
When is it appropriate to add dextrose to saline IV fluids in a patient with DKA?
When serum glucose reaches 200mg/dL
400
What are the indicators of resolution of DKA?
Normalization of the serum anion gap
Patient is able to eat.
400
Severe hypokalemia can result in cardiac ______.
Arrhythmias
400
Mental status is typically characterized as _____ in a patient with moderate DKA.
Drowsy
400
When is a multiple dose SQ insulin schedule initiated in the course of treatment for a patient with DKA?
When the ketoacidosis has resolved and the patient is able to eat.
400
What are the two major reasons for infusing isotonic saline in a patient with DKA or HHS?
1. Expand extracellular volume
2. Stabilize cardiovascular status
500
When is bicarbonate suggested to be administered in the treatment of DKA?
Arterial pH of <6.9
500
Low dose IV insulin should be administered to all patients with moderate to severe DKA who have a serum potassium > or = to ____mEq/L.
3.3
500
Mental status is typically characterized as _____ in a patient with HHS.
Stupor/coma
500
SQ rapid-acting insulin analogs may be used safely in patients with _____ (mild, moderate, severe) DKA on a general medical ward if glucose is monitored every _____ (time).
mild;hour
500
Reducing osmolality too rapidly with fluid replacement may cause what serious complication?