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N265 Concept Map (DKA and HHS)
- Course
- NURSING FUNDAMENTA
- Institution
- East Los Angeles College
Concept map of the complications with diabetes ketoacidosis and hyperosmolar Hyperglycemic state.
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Chiang, 1Complications of Diabetes
Mellitus
Diabetic Ketoacidosis: Hyperglycemic hyperosmolar
Hyperglycemia (>300mg/dL) with state:
accumulation of ketones (Key point: NO Hyperglycemia (>600mg/dL) and absence of
insulin) ketosis (Key point: Not enough insulin
Risk Factors: Risk Factors:
1. Undiagnosed or untreated type 1 DM or 1. Lack of sufficient insulin r/t to DM
nonadherence to diabetic regimen 2. Inadequate fluid intake or poor kidney
2. Any condition that increases carbohydrate functions
metabolism (stress, illness) 3. More common in ppl age 50-70 years old
3. Infection 4. Higher mortality rate in older ppl (40-70%)
4. Increased hormone production that stimulates the 5. Infection, stress, MI, Sepsis
liver to produce glucose and decreases the effect of 6. Medications: glucocorticoids, diuretics,
insulin phenytoin, beta and calcium blockers
Expected Findings: Expected Findings:
1. Polyuria (Excess urine) 1. Polyuria (Excess urine)
2. Polydipsia (Excess thirst) 2. Polydipsia (Excess thirst)
3. Polyphagia (Excess hunger) 3. Polyphagia (Excess hunger)
4. Weight loss (No insulin, no glucose breakdown) 4. Weight loss (No insulin, no glucose breakdown)
5. GI effects: Nausea, vomiting, abdominal pain 5. Blurred vision, headache, weakness
6. Blurred vision, headache, weakness 6. Orthostatic hypotension (result from lack of
7. Orthostatic hypotension (result from lack of fluid) fluid)
8. Fruity odor of breath (Elevated ketone bodies) 7. Mental status change (no glucose to brain)
9. Kussmaul respirations 8. Seizures, myoclonic jerking (blood osmolarity
10. Metabolic acidosis (breakdown of stored glucose, >350mOsm/L)
protein, and fat to produce ketone bodies) 9. Reversible paralysis (Elevated blood osmolarity;
11. Mental status change (no glucose to brain) coma if >350mOsm/L)
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