DKA Pathophysiology
What hormone deficiency leads to DKA?
What is Insulin
In DKA patients, the glucose will be greater than what number ?
what is 200.
What is the first fluid used in a DKA resuscitation?
What is Isotonic fluid (LR or NS 10-20ml/kg to restore peripheral circulation)
What is the insulin route used in DKA management?
What is a continuous IV infusion
Your patient can transition to Sub Q insulin when the pH is ?
What is > 7.3
What causes metabolic acidosis in DKA patients?
Ketone production from fat breakdown
What ABG finding indicates severe DKA?
What is a pH less than 7.1
Insulin infusion should be started where ?
What is in the ER
Why is a insulin bolus or injection avoided in DKA?
What is a rapid glucose drop can cause cerebral edema
Sodium Bicarbonate level should be greater than ___ as secondary criteria to transition.
Why are patients often tachypneic?
Tachypnea and Kussmaul respirations are to compensate for the acidosis
In mild and moderate DKA, how often do we perform labs (CBC, ABG, RFP, etc.) on our patients?
What is every 6 hours, its every 4 hours for severe DKA patients.
When is dextrose started in our 2 bag system for IV fluids?
When the patients glucose is below 300
How often do you check your patients glucose levels while on a Insulin infusion?
What is every hour
What is 2
What is lipolysis.
Potassium levels in DKA patients are often?
What is high, as the acidosis shifts the k+ out of the cells.
Why are fluid boluses cautiously given in kids with DKA?
What is the risk of Cerebral Edema
What is the starting Insulin rate per our protocol here at JDCH?
0.1 units/kg/Hr
(when blood glucose is above 150 g/dl)
Who do you call once your patient has met the criteria for transitioning to Sub Q insulin ?
Who is the Endocrinology team.
The acid responsible for metabolic acidosis in DKA?
what is beta-hydroxybutyrate.
Bicarbonate levels seen in DKA patients are ?
What electrolytes are usually added in the IVF's via 2 bag system?
What is potassium and phosphorus (if the K+ is < 5.5)
What should the Insulin rate be reduced to if the glucose level is less than 100 mg/dl?
what is 0.05 units/kg/Hr
How long after you have given the Sub Q insulin do you wait to turn off the Insulin infusion?
What is 60 minutes.