DKA
What are the 3 diagnostic criteria for DKA?
Hyperglycemia, ketonemia/ketonuria, metabolic acidosis
What is the first-line treatment for mild to moderate dehydration in AGE
ORT
Why are children with T1DM at risk of DKA during illness?
because in illness their body is in a state of stress and will have increased energy demand/release if counter reg hormones
What is the first treatment in DKA?
IV fluids (perfusion first!)
What is first line drug given in mild to moderate dehydration?
Ondansetron
Which Canadian provinces have high incidence of T1DM
Quebec and Newfoundland
What lab value confirms DKA resolution?
normalization of pH
Calculate the min fluid requirement/treatment for a 20kg child diagnosed with severe dehydration.
child is in severe dehydration. Children get 10-20cc/kg IV fluid bolus. So in this case min bolus amount = 200ml fluid bolus of isotonic IV fluid (NaCl)
What education should be reinforced at discharge after a DKA episode? (min 3)
Sick day management, ketone monitoring, insulin adherence, and follow-up care, s/s of DKA
What signs may indicate cerebral edema? (List min 4)
Headache, irritability, vomiting, bradycardia, wide pulse pressure, irregular resp, desaturations
What foods would you teach parents to avoid for a client diagnosed with AGE (min 4)?
e.g. Sugary foods, spicy foods, milk, gatorade, fatty foods, acidic food
list 3 roles of counter regulatory hormones in blood glucose management/T1DM
*bonus 100pts, list the counter-regulatory hormone released by the pancreas and its role
-glycogenolysis, gluconeogenesis, lipolysis, ketogenesis
BONUS: glucagon- glycogenolysis
What is the purpose of the 3-bag system in DKA?
To adjust dextrose, fluids, and insulin rates safely and flexibly during treatment
A 2 year old child comes in with sunken eyes, diarhea, low urine output, irritability, dry mucous membranes. They currently weigh 9.5kg. Their weight 1 week ago was 10kg. Vitals are HR= 150bpm, BP= 100/60. What stage of dehydration are they in? What is their recommended treatment? Calculate it.
Moderate (BP normal. LOC impacted but not severe). ORT (50-100ml/kg over 4hr, so 475-950ml over 4hr)
Signs and Symptoms of T1DM with their rationales (min 3 s/s with rationale for each)
polyuria, polydipsia, polyphagia, weight loss, cognitive concerns, poor wound healing, fatigue