How do you nurse a DKA patient?
Nursing Management
- Monitor vitals.
- Check blood sugars and treat with insulin as ordered.
- Start two large-bore IVs.
- Administer fluids as recommended.
- Check electrolytes as potassium levels will drop with insulin treatment.
- Check renal function.
- Assess mental status.
- Look for signs of infection (a common cause of DKA)
What is the primary nursing diagnosis for DKA?
Nursing Diagnosis: Nausea related to depletion of sodium and potassium levels in the body secondary to diabetic ketoacidosis (DKA), as evidenced by gagging sensation, uremia, vomiting, presence of ketones in the blood or urine, and frequent urination.
What is the priority intervention for DKA?
The initial priority in the treatment of diabetic ketoacidosis is the restoration of extra-cellular fluid volume through the intravenous administration of a normal saline (0.9 percent sodium chloride) solution.
What technique of assessment helps ketoacidosis?
In order to test for hyperglycaemia and ketonaemia, blood glucose and ketone levels should initially be checked by carrying out a finger prick test. A result of greater than 11mmols/L of glucose and 3mmols/L or more of ketones may be an indication of DKA (Savage, 2011; Savage et al, 2011).
What are the goals of nursing management of the patient with diabetic ketoacidosis?
The aim of insulin therapy in DKA management is to suppress ketogenesis, reduce blood glucose and correct electrolyte imbalance. Insulin therapy increases peripheral glucose use and decreases hepatic glucose production, thereby lowering blood glucose concentration.
What are the three key actions for the management of DKA?
Key DKA management points
- Start intravenous fluids before insulin therapy.
- Potassium level should be >3.3 mEq/L before the initiation of insulin therapy (supplement potassium intravenously if needed).
- Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h.
How do you monitor DKA?
Patients should be monitored closely and frequently. Blood glucose should be evaluated every one to two hours until the patient is stable, and the blood urea nitrogen, serum creatinine, sodium, potassium, and bicarbonate levels should be monitored every two to six hours depending on the severity of DKA.
Why is potassium given in DKA?
Replacement of potassium in intravenous fluids is the standard of care in treatment of DKA to prevent the potential consequences of hypokalemia including cardiac arrhythmias and respiratory failure.
What glucose level is DKA?
Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor.