Diabetic ketoacidosis nursing management

dka

1. YASH RAMAWAT M.N. FINAL

2. Diabetes meaning a disorder of the metabolism causing excessive thirst and the production of large amounts of urine. Ketoacidosis Pathological metabolic state associated with high concentrations of  ketone bodies

3. Meaning of diabetic ketoacidosis …. A serious pathological metabolic state in which excessive amount of keton bodies accumulate in body due to lack of insulin ……….

4. How lack of insulin develop acidosis

5. Insulin Deficiency Glucose uptake Proteolysis Lipolysis Amino Acids Glycerol Free Fatty Acids Gluconeogenesis Glycogenolysis Hyperglycemia Ketogenesis Acidosis Osmotic diuresis Dehydration PATHOPHYSIOLOGY

6. Signs and Symptoms of DKA Polyuria, polydipsia Enuresis Dehydration Tachycardia Orthostasis Abdominal pain Nausea Vomiting Fruity breath Acetone Kussmaul breathing Mental status changes Combative Drunk Coma

7. Counterregulatory Hormones - DKA Increases insulin resistance Activates glycogenolysis and gluconeogenesis Activates lipolysis Inhibits insulin secretion Epinephrine X X X X Glucagon X Cortisol X X Growth Hormone X X X

8. Nursing Diagnosis FLUID VOLUME DEFICIT RELATED TO: OSMOTIC DIURESIS DUE TO HYPERGLYCEMIA, EXCESSIVE DISCHARGE: DIARRHEA, VOMITING; RESTRICTION INTAKE DUE TO NAUSEA, MENTAL MESS .   MBALANCED NUTRITION: LESS THAN BODY REQUIREMENTS RELATED TO: INSUFFICIENCY OF INSULIN, DECREASED ORAL INPUT, HIPERMETABOLISME STATUS

9. RISK FOR INFECTION (SEPSIS) RELATED TO: INCREASED LEVELS OF GLUCOSE, DECREASED LEUKOCYTE FUNCTION, CHANGES IN THE CIRCULATION . RISK FOR SENSORY-PERCEPTUAL ALTERATIONS RELATED TO: KETIDKSEIMBANGAN GLUCOSE / INSULIN AND / OR ELECTROLYTES.

10. FATIGUE RELATED TO: DECREASED METABOLIC ENERGY PRODUCTION, INSUFFICIENCY OF INSULIN, INCREASING ENERGY DEMAND.