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Beschreibung
Mindmap von Nkechi Juliana Ugochukwu, aktualisiert more than 1 year ago
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Erstellt von Nkechi Juliana Ugochukwu
vor etwa 7 Jahre
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Diabetic ketoacidosis
- Definition
- Diabetic Ketoacidosis (DKA) is an acute and
potentially fatal complication of diabetes typically
characterized by hyperglycaemia, ketone body
formation and metabolic acidosis. (Gosmanov et al,
2014
- Diabetic Ketoacidosis (DKA) is an acute and
potentially fatal complication of diabetes typically
characterized by hyperglycaemia, ketone body
formation and metabolic acidosis. (Gosmanov et al,
2014
- Etiology
- dehydration owing to illness with vomiting or diarrhea
- insulin not taken as prescribed, or omitted
- infection
- inadequate treatment of existing diabetic mellitus
- change in diet, insulin or exercise regimen
- Undiagnosed diabetic mellitus
- dehydration owing to illness with vomiting or diarrhea
- Pathophysiology
- It is caused by a relative or absolute deficiency of insulin that
stimulates lipolysis resulting in the productionof acetyl coA from
fattyacid when combined with increased levels of stress. the lack
of insulin in DKA results in decreased glucose utilization and
increased gluconeogenesis. This acetyl coA acts as the substracte
for hepatic sythesis of ketone bodies (acetoacetate, beta
hydroxybuthrate and acetone.
- It is caused by a relative or absolute deficiency of insulin that
stimulates lipolysis resulting in the productionof acetyl coA from
fattyacid when combined with increased levels of stress. the lack
of insulin in DKA results in decreased glucose utilization and
increased gluconeogenesis. This acetyl coA acts as the substracte
for hepatic sythesis of ketone bodies (acetoacetate, beta
hydroxybuthrate and acetone.
- Clinical manifestation
- Signs : Polyuria & Polydipsia leading to dehydration manifested by poor
skin turgor, dry mucous membranes, tachycardia & orthostatic
hypotension
- Symptoms: Lethargy & weakness, dry & loose skin, sunken eye sockets
and vomiting. Abdominal pain is occasionally seen. Kussmaul's
respirations and acetone- a sweet fruity odour on the breath.
- lab findings; Blood glucose level > 14mmol/L, arterial blood pH < 7.35,
serum bicarbonate level < 15 mmol/L and ketones in the blood & urine.
- Signs : Polyuria & Polydipsia leading to dehydration manifested by poor
skin turgor, dry mucous membranes, tachycardia & orthostatic
hypotension
- Collaborative care
- Admnistration of IV fluids
- Assessment of blood and urine
- Assessment of cardiovascular and respiratory status
- Electrolyte replacement
- Assessment of blood glucose levels
- central venous pressure monitoing (if indicated
- ECG monitoring
- Assessment of mental status
- Recording of intake and output
- IV administration of rapid or short-acting insulin
- Admnistration of IV fluids
- Nusing intervnetion
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