How do you manage a patient with diabetic ketoacidosis?

How do you manage diabetic ketoacidosis?

Key DKA management points

  1. Start intravenous fluids before insulin therapy.
  2. Potassium level should be >3.3 mEq/L before the initiation of insulin therapy (supplement potassium intravenously if needed).
  3. Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h.

What is the priority intervention for a patient with diabetic ketoacidosis?

After initial stabilization of circulation, airway, and breathing as a priority, specific treatment of DKA requires correction of hyperglycemia with intravenous insulin, frequent monitoring, and replacement of electrolytes, mainly potassium, correction of hypovolemia with intravenous fluids, and correction of acidosis.

What to do if someone is experiencing signs of diabetic ketoacidosis?

Elevated ketones are a sign of DKA, which is a medical emergency and needs to be treated immediately. Go to the emergency room or call 911 right away if you can’t get in touch with your doctor and are experiencing any of the following: Your blood sugar stays at 300 mg/dL or above. Your breath smells fruity.

What are the three goals in the treatment of diabetic ketoacidosis?

The goals of DKA treatment are to normalize fluid-volume status, hyperglycemia, electrolytes, and ketoacidosis.

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What IV fluids are given for DKA?

Normal saline (0.9% sodium chloride) is the most commonly used intravenous fluid in treating DKA, but it has a very high concentration of chloride and can lead to additional acid production when given in large volumes.

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.

How can you prevent diabetic ketoacidosis?

There’s much you can do to prevent diabetic ketoacidosis and other diabetes complications.

  1. Commit to managing your diabetes. Make healthy eating and physical activity part of your daily routine. …
  2. Monitor your blood sugar level. …
  3. Adjust your insulin dosage as needed. …
  4. Check your ketone level. …
  5. Be prepared to act quickly.

What triggers diabetic ketoacidosis?

In general diabetic ketoacidosis occurs because there is not enough insulin to move sugar (glucose) into the cell where it can be used for energy. Besides lack of insulin, certain body stressors combined with diabetes, such as infection or illness, can trigger diabetic ketoacidosis.

What happens during diabetic ketoacidosis?

Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. It occurs when the body starts breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic.

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How do you reduce ketones?

Also try these steps to bring down your ketone levels:

  1. Drink extra water to flush them out of your body.
  2. Test your blood sugar every 3 to 4 hours.
  3. Don’t exercise if you have high blood sugar and high ketones.

Why use half normal saline in DKA?


The goal of treating DKA is to slowly allow the BG and hyperosmolality to normalize, which initially requires the use of isotonic fluids, i.e. normal (0.9%) saline.