Classic Signs/Symptoms
polydipsia, polyuria, weight loss
What are early signs and symptoms of diabetes type I ?
the body's inability to produce insulin generally due to the autoimmune destruction of the beta cells in the pancreas.
What is Type I diabetes?
insulin 0.1 unit/kg/hr
What is the insulin drip dose?
slow rehydration, 1.5 to 2 times maintenance fluid
What is how we rehydrate DKA patients with hypertonic dehydration
shakiness, headache, clammy skin, sweating, hunger, muscle weakness, fatigue
What is hypoglycemia?
2 laboratory values-Ph & Bicarb.
What lab markers determine the classification/severity of DKA?
Decrease blood glucose 50-100 mg/dl/hr
What is how fast blood glucose should drop every hour
What is Ketoacidosis?
glycated hemoglobin(A1C)
What is the test that monitors the child's average blood sugar over 3 months?
blood glucose <250-300 mg/dl
What are the glucose parameters for adding glucose to maintenance fluids?
2 oz. orange juice, 8 oz skim milk, or 2-4 glucose tabs
What is the management of hypoglycemia?
this hormone facilitates the entrance of glucose into the cells of the body
What is Insulin
dehydration, hyperglycemia, metabolic acidosis, and ketonuria
What is the clinical presentation of DKA
add 1.6 mEq/L Na for every 100mg/dl glucose
What is how to calculate true Na levels.
mannitol dose of 0.5-1.0 gram/kg over 20 minutes or 3% saline (5-10ml/kg) over 30 minutes.
What is the treatment for cerebral edema?
Ph of >7.30, mild acidosis, improvement and patient states they are hungry.
What are indications that oral fluids can be introduced?
in the absence of insulin, the body uses free-fatty acids as a primary energy source.
What leads to the formation of keto-acids and metabolic acidosis?
decreased level of consciousness, agitation, incoherence, seizures, emesis, headache
What are signs and symptoms of cerebral edema
Ph <7.1 & HCO-3 <5
What is severe DKA?
NS +13mmol KPhos/L +20 KAcetate/L and D10 NS +13 mmol KPhos/L + 20meq KAcetate/L
What is the 2-bag system to treat DKA?
before meals, bedtime and 2 am.
What is the daily schedule for BS on a transitioning patient?
blood glucose >250 mg/dl, arterial pH 7.30 or less, serum bicarb 18 mEq/L or less, and ketones present
What are lab values associated with DKA