Completed DKA HHS homework.docx

Completed DKA HHS homework.docx - DKA HHS 1 Diabetic...

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DKA & HHS 1 Diabetic Ketoacidosis – DKA Is there insulin in the body? DKA is caused by an absence or marked decrease in insulin in the body. What are the three main clinical features of DKA? Hyperglycemia/ dehydration and electrolyte loss/ acidosis What is the liver doing related to glucose? Increasing its release of glucose via gluconeogenesis ( the production of glucose, especially in the liver, from amino acids, fats, and other substances that are not carbohydrates) What are the kidneys doing related to glucose? Excreting glucose along with fluids and electrolytes in an attempt to rid the body of excess glucose. What is lipolysis? The breakdown of fat How does lipolysis relate to DKA? Lipolysis breaks down fat into free fatty acids and glycerol. These products are converted into Ketone bodies by the liver. Which of the following blood gases would best represent a patient with DKA? 1. pH 7.45, CO2 35, HCO3 25, pO2 90 2. pH 7.35, CO2 38, HCO3 22, pO2 87 3. pH 7.25, CO2 48, HCO3 28, pO2 78 4. pH 7.21, CO2 28, HCO3 16, pO2 75 What causes DKA? 1. Decreased or missed dose of insulin 2. Illness or infection 3. Undiagnosed/untreated DM What are ‘sick day rules’? For prevention of DKA related to illness, “sick day rules” for managing diabetes when ill should be reviewed with patients. The most important concept in this is to never eliminate insulin doses when nausea and vomiting occur. Instead, the patient should take the usual insulin dose (or SP 2017
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DKA & HHS 2 previously prescribed special sick day doses) and then attempt to consume frequent small portions of carbohydrates (including foods usually avoided, such as juices, regular sodas, and gelatin). Drinking fluids every hour is important to prevent dehydration. Blood glucose and urine ketones must be assessed every 3 to 4 hours. When should a patient be advised to call their healthcare provider?
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