Patho
Is thought to be autoimmune; absolute deficiency of insulin
What is Type I diabetes
True or false; diabetic ketoacidosis labs would show hyperosomolality?
What is true
When a DKA patient is first admitted the immediate medical intervention is this?
What is fluid replacement with NS
2 complications of diabetic ketoacidosis
What is cerebral edema, vascular collapse, hypokalemia, hyperkalemia, seizure, shock, decreased LOC, renal failure, hypotension
The normal pH range for a human
What is 7.35-7.45?
DKA is more common in this type of diabetes.
What is type 1
What would be the pH of a patient with severe diabetic ketoacidosis?
What is <7.1
In the later treatment of DKA, this may be added to an IV fluid to prevent hypoglycemia.
What is dextrose
Name one sign or symptom of hypervolemia
What is neck vein distention, pulmonary crackles and edema, palpable liver edge, respiratory distress
If a patient has 45 grams of carbohydrates on their tray and their carbohydrate ratio is 15, this would be their carbohydrate bolus of insulin.
What is 3 units of insulin.
This is one of the hormones that is released to promote gluconeogenesis.
What is Glucagon or catecholamines (epinephrine/norepinephrine)
Would your electrolytes (K, Na) initially be low or high for a patient with diabetic ketoacidosis?
What is high
This medication is the cornerstone of DKA therapy and is given as a continuous infusion.
What is insulin
What should be started first- volume replacement or insulin?
What is volume replacement
The calculated total insulin bolus is 4.6 but you will actually give this amount:
What is 5 units
These are a bi-product of fat tissue breakdown that causes acidosis in the body.
What are ketones
What would your bicarbonate level be for a patient with diabetic ketoacidosis?
What is <15 mmol/L
Insulin drives this electrolyte back into the cells?
What is K+
You infuse this after the blood glucose level is 14 mmol/L
What is D5NS or D10NS
pH 7.49, pCO2 40, HCO3 is 29 is called this:
What is metabolic alkalosis
When ++ glucose is present and leaves the tubules and takes ++H2O, Na+, K+, ammonium, phosphate and other salts with it, this process is occurring.
What is osmotic diueresis
(T or F) A patient with diabetic ketoacidosis would have a serum glucose lab value of more than 11 mmol/L
What is true
Precipitating factors in DKA (must give 3)
What are:
poor control, missed insulin, illness, medications, drugs & alcohol
The replacement of this blood gas is controversial in the treatment of DKA and is generally not used, but it has been shown to have some effect if the pH is less than 7.0.
What is bicarbonate
This intervention may help with abdominal bloating and discomfort for a patient who presents with DKA?
What is put in a nasogastric tube
This many mmol of potassium are added per 1000 mL of fluids after a patient voids in DKA
What is 40 mmol?