DKA HHS PPT FA17.pptx - Diabetic Ketoacidosis(DKA and...

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Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS)
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Diabetic Ketoacidosis (DKA)
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Pathophysiology Insulin deficiency Uncontrolled Hyperglycemia (>300) Osmotic diuresis: Dehydration and electrolyte loss Increased Ketone production Metabolic Acidosis
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History Diabetes Infection Stress Others?
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Clinical Manifestations Polyuria, Polydipsia, Polyphagia Weight Loss N/V Abdominal pain Lethargy, Mental Status Changes Shock, coma What else….??
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Laboratory Assessment Glucose >300 mg/dL Serum Osmolarity varies Serum Ketones + Urine Ketones + Serum pH <7.35 Serum HCO 3 <15mEq/L Serum Na (low, normal, or high) Serum K+ (usually high before tx then drops) BUN >30mg/dL Creatinine >1.5mg/dL
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Glucose
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Blood Glucose Management Airway LOC Hydration Status Electrolytes Blood Glucose Insulin Infusion Protocol
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Fluid and Electrolyte Management Kidney function and electrolyte tests continue hourly 1. First Hour: 0.9% NS IV @ 1L/hour
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