Diabetic Ketoacidosis Questions And Answers Graded A+

2) Imbalanced nutrition: less then body requirements r/t decreased oral intake: anorexia, and altered consciousness. Evidenced by history of flu for 1 week with vomiting and anorexia. - ️️NI: Weigh daily or as ordered. Provide liquids containing nutrients and electrolytes as soon as patient can tolerate oral fluids then progress to a more solid food as tolerated. Observe for signs of hypoglycemia: changes in LOC, cold and clammy skin, rapid pulse, hunger, irritability, anxiety, headache, lightheadedness, shakiness. 3) Risk for Infection r/t risk factors such as malnutrition and Diabetes mellitus. - ️️NI: Assess temperature every four hours. Notify physician if fever occurs. Fever is a sign of an infection. Infection is the most common cause of diabetic ketoacidosis (DKA). Monitor for signs of infection (e.g., fever, rhonchi, dyspnea, and/or cough). These are indicators of pneumonia which is common among patients with DM. Teach the patient and family about infectious process, routes, pathogens, environmental factors, and aspects of prevention. Provides basic knowledge for self-help and selfprotection. Clinical manifestations: - ️️Early symptoms of DKA present with lethargy and weakness. Additional signs are dehydration evident by poor skin turgor, dry mucous membrane, tachycardia, orthostatic hypotension, and sunken eyeballs. More symptoms are abdominal pain with anorexia and vomiting. The presence of sweet, fruity odor on breath, which indicates acetone. Lastly, Kussmaul respirations (rapid and deep breathing associated with dyspnea) due to body's attempt to reverse metabolic acidosis through exhalation of excess of carbon dioxide. Diabetic Ketoacidosis - ️️results from severe insulin deficiency. Insulin deficiency causes the body to use fat for energy rather than glucose. Ketones are a result of fat metabolism and excessive amounts alter blood pH leading to metabolic acidosis Diagnostic Studies: - ️️Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Laboratory findings include: blood glucose level greater than or equal to 250 mg/dL (13.9 mmol/L), arterial blood pH less than 7.30, serum bicarbonate level less than 16 mEq/L (16 mmol/L), moderate to large ketones in the urine or serum. DKA - ️️A lack of insulin also stimulates over production of glucose from proteins. This leads to hyperglycemia, which results in diuresis. Excessive excretion of fluids results in electrolyte imbalance and dehydration. DKA is a medical emergency and if left untreated it leads to death as a result of renal failure and hypovolemic shock. DKA Symptoms - ️️include hyperglycemia, ketosis, acidosis and dehydration. It is most common on Type 1 diabetic patients, however, type 2 diabetic patients may alsoacquire it as a result of ineffective diabetes management, infection, and stress such as severe illness Medications: - ️️Antidiabetics, hormones, insulin is used to control of hyperglycemia in patients with diabetes mellitus. It lowers blood glucose by: stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production. Drug dose depends on blood glucose, response, and many other factors Nursing diagnosis: 1) Deficient Fluid Volume r/t excessive gastric losses as evidenced by dry skin and vomiting for 1 week. - ️️NI: Monitor vital signs, Note orthostatic BP changes, monitor I & O and note urine specific gravity. Maintain fluid intake of at least 2500 mL/day within cardiac tolerance when oral intake is resumed. Investigate changes in LOC. 2) Imbalanced nutrition: less then body requirements r/t decreased oral intake: anorexia, and altered consciousness. Evidenced by history of flu for 1 week with vomiting and anorexia. - NI: Weigh daily or as ordered. Provide liquids containing nutrients and electrolytes as soon as patient can tolerate oral fluids then progress to a more solid food as tolerated. Observe for signs of hypoglycemia: changes in LOC, cold and clammy skin, rapid pulse, hunger, irritability, anxiety, headache, lightheadedness