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IOS 9 Exam 4

DKA

QuestionAnswer
Most frequent precipitating factors of DKA Increased glucose, acidosis, ketones
Lack of insulin can be increased by Acute infection, illness, UTI, stress, stopping insulin therapy
Lack of insulin causes Decrease in glocuse utilization, Increase in Gluconeogenesis(Hyperglycemia-Osmotic diuresis=dehydration-acidosis), Lipolysis(FFA= ketogenesis,lactic acidosis)
Adipsoe tissue decrease in insulin causes lipolysis causing increase
Clinical Presentation of DKA patient N/V (decreased pH), thirst (hyperosmolar), Acetone breath, weakness
Labs found in DKA Glucose>250mg/dL, Acidosis pH<7.3, HCO3<15, ketonemia,hypokalemia or hyper or normal, anion gap
How to calculate anion gap (Na)-(Cl+HCO3) normal 12-17
Hyperglycemia non-ketone state Usually Type 2 since it is insulin resistance, and volume depletion
Treatment for DKA 0.9% saline (1L/hr- when glucose >250 D5/0.45% saline), 0.1U/kg bolus insulin then 0.1U/kg constant infusion (Chem 7 qhr to monitor drop) NPH then stop infusion 1-2 hours later, and potassium 10mq/L IV
Complications which may be seen in patients with DKA Hypoglycemia, hypokalemia, Hyperglycemia secondary to interruption w/out coverage
Created by: liza001
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