Should DKA patients be kept NPO?
Diet: Patients should be kept NPO until their blood sugar is < 250mg/dl, their anion gap has normalized, and they are feeling well enough to eat. Once through the acute phase above, patients may be offered a diet and should have prandial insulin ordered as well.
What are criteria of DKA resolution?
The resolution of DKA is reached when the blood glucose is < 200 mg/dl, serum bicarbonate is ≥15 mEq/L, pH is >7.30 and anion gap is ≤12 mEq/L (17). HHS is resolved when serum osmolality is < 320 mOsm/kg with a gradual recovery to mental alertness. The latter may take twice as long as to achieve blood glucose control.
When do you give Bicarb to DKA?
Consensus guidelines for the management of DKA recommended administering sodium bicarbonate to DKA patients who present with an initial blood gas pH of < 7.0. That recommendation was updated and changed in 2009 to limit sodium bicarbonate use to DKA patients with blood gas pH of < 6.9.
When do you give potassium in DKA?
About two-thirds of patients will develop hypokalemia in the course of treatment for DKA. Potassium repletion should commence once the serum potassium falls below 5.3 mEq/L if patients have normal renal function. Twenty to 30 mEq of potassium may be supplemented to each liter of fluids.
Why is co2 low in DKA?
Acidosis in DKA is due to the overproduction of β-hydroxybutyric acid and acetoacetic acid. At physiological pH, these 2 ketoacids dissociate completely, and the excess hydrogen ions bind the bicarbonate, resulting in decreased serum bicarbonate levels.
Do you give potassium before insulin in DKA?
The American Diabetes Association (ADA) and International Society for Pediatric and Adolescent Diabetes (ISPAD) consensus statements for managing DKA recommend checking serum potassium prior to insulin treatment and ongoing monitoring of serum potassium levels with replacement in intravenous fluids (3, 4).
Why is Bicarb low in DKA?
Why bicarbonate is contraindicated in DKA?
When do you give nahco3 in DKA?
Why does Kussmaul breathe in DKA?
Here’s an explanation of how diabetic ketoacidosis can lead to Kussmaul breathing: Extra ketones in your body cause acid to build up in your blood. Because of this, your respiratory system is triggered to start breathing faster.
Why do we give dextrose in DKA?
Why is IV dextrose given to patients with DKA? When the serum glucose reaches 200 mg/dL in a patient with diabetic ketoacidosis (DKA), IV dextrose is added to avoid the development of cerebral edema. In addition, the rate of insulin infusion may need to be slowed down to between 0.02 and 0.05 units/kg/hr.
When should you give Bicarb in DKA?
How to determine DKA?
Cerebral oedema is the key life-threatening complication of DKA
What labs indicate DKA?
How to manage DKA?
Management. Children and adolescents with DKA should be managed in a unit that has: Access to laboratory services for frequent and timely evaluation of biochemical variables; Experienced nursing staff trained in monitoring and management of DKA in children and adolescents
What happens If DKA is not treated?
One of the ketone bodies formed (acetone) leaves the body via the lungs, giving the breath of the person with DKA a characteristic, fruity smell. This is how DKA can be detected. DKA can induce coma or even death if not treated immediately. Signs & symptoms of DKA: