DIABETIC KETOACIDOSIS

(DKA) is an acute, major, life-threatening complication of diabetes

characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs
when absolute or relative insulin deficiency inhibits the ability of glucose
to enter cells for utilization as metabolic fuel, the result being that the
liver rapidly breaks down fat into ketones to employ as a fuel source. The
overproduction of ketones ensues, causing them to accumulate in the
blood and urine and turn the blood acidic. DKA occurs mainly in patients
with type 1 diabetes.

Causes of DKA

 Heart attack or stroke.

 Physical injury, such as from a car accident.
 Alcohol or drug use.
 Certain medicines, such as some diuretics (water pills) and corticosteroids
(used to treat inflammation in the body).

Signs and Symptoms

 Fast, deep breathing.

 Dry skin and mouth.
 Flushed face.
 Fruity-smelling breath.
 Headache.
 Muscle stiffness or aches.
 Being very tired.
 Nausea and vomiting.
Nursing Management

1. Monitor vitals.
2. Check blood sugars and treat with insulin as ordered.
3. Start two large-bore IVs.
4. Administer fluids as recommended.
5. Check electrolytes as potassium levels will drop with insulin treatment.
6. Check renal function.
7. Assess mental status.
8. Look for signs of infection (a common cause of DKA)

PROPER MANAGEMENT OF DKA

Prompt initiation of iv fluids

Insulin therapy

Electrolytes replacement and recognition

Treatment of precipitating causes.

Close monitoring of patient's condition by regular clinical and laboratory

data and the use of management protocols help ensure better outcomes.