Diabetic Ketoacidosis
Pathophysiology
- Present in Type 1 diabetes - Lack of insulin related to undiagnosed type 1 diabetes or nonadherence to diabetic regimen
A nurse is teaching the guardian of a school aged child who has diabetes mellitus how to recognize diabetic ketoacidosis. Which of the following findings should the nurse identify as a manifestation of this complication?
A. Slow heart rate B. protruding eyeballs C. deep rapid respirations D. decrease urine output C. Deep rapid respirations Deep rapid respirations or Kussmaul respirations are a manifestation of DKA
A nurse is caring for a client who has diabetic ketoacidosis. Which of the following findings should the nurse expect?
A. Urine negative for ketones B. Distended neck veins C. Kussmaul respirations D. Elevated blood pressure C. Kussmaul respirations Kussmaul respirations is a manifestation of DKA. A client with Kussmaul respirations may have deep rapid respirations
Medication
- 0.9% Normal Saline - Hourly blood sugar checks - Over 350 blood sugar give regular inulin IV ONLY - below 200 blood sugar (ketones resolve) SQ insulin + D50 IV -Add potassium K+ during insulin
Signs and Symptoms
- Polydipsia, polyuria, polyphagia - Kussmaul respirations, ketones (fruity breath) - Weight loss, metabolic acidosis - G.I. Effects (N/V, abdominal pain)
A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has a blood glucose level of 250 mg/dL? Which of the following actions should the nurse make?
A. Administer 5% dextrose in 0.9% normal saline by continuous IV infusion B. Give potassium as a rapid IV bolus C. Administer 4 units of ultralente insulin SQ D. Obtain HBA1C Stat A. administer 5% dextrose in 0.9% normal saline by continuous IV This brings the sugar down slowly
A nurse caring for a client with diabetic ketoacidosis who has a prescription for an intravenous infusion of insulin. The nurse should document which of the following types of insulin was administered intravenously to treat diabetic ketoacidosis?
A. Regular Insulin B. Insulin lispro C. Insulin Aspart D. Insulin Glargine A. regular insulin regular insulin is the only insulin that can be administed IV and to treat ketoacidosis because of its rapid onset
A charge nurse on a pediatric unit receives the laboratory results for several clients. Which of the following results should the nurse report to the provider?
A. WBC 15,800- bacterial infection B. Calcium level 8.7 chronic kidney disease C. Blood glucose 375 DKA D.HCT 32%- leukemia C. Blood glucose 375 DKA DKA is a life threatening complication of type 1 diabetes. This client should receive regular insulin IV
A nurse is reviewing laboratory values of a client who has diabetic ketoacidosis. Which of the following laboratory values is consistent with diabetic ketoacidosis?
A. blood glucose 30 mg/dL B. negative ketones in urine C. Blood pH 7.38 D. Bicarbonate level 12 mEq/L D. Bicarbonate 12 mEq/L A client with diabetic ketoacidosis should have bicarbonate level of <15 mEq/L
A nurse in the emergency department is caring for client who has a fruity breath odor, a dry mouth, and extreme thirst. Which of the following assessments should the nurse make?
A. blood glucose level B. pupillary reaction to light C. Deep tendon reflexes D. Liver function tests A. Blood glucose level Polydipsia, polyphagia, and ketones are manifestations of DKA Diabetic Ketoacidosis. The nurse should check the client's blood glucose level
