DIABETIC KETOACIDOSIS
SHORT NOTES
- A life-threatening complication of Type-1 Diabetic Mellitus that develops when a severe insulin deficiency occurs
PRECIPITATING FACTORS
- Infection
- Inadequate insulin dose
SIGNS AND SYMPTOMS
- Kussmaul respiration
- Fruity breath nausea, abdominal pain, dehydration, polyuria, polydipsia, weight loss, dry skin, sunken eyes, coma
LABORATORY FINDINGS
- Serum glucose more than 300mg/dL
- Urine ketones=positive
TREATMENT
- Treat dehydration with rapid infusion of 0.9% or 0.45% normal saline as prescribed
- Dextrose added to IV fluids when the blood glucose level reaches 250 to 300 mg/dL
- Treat hyperglycemia with insulin administration intravenously as prescribed
- Correct electrolyte imbalances(potassium level may be elevated as a result of dehydration and acidosis)
- Use short-duration insulin only
- Monitor vital signs and urine output, potassium, and hourly glucose levels.
- Monitor the client being treated for DKA closely for signs of increased intracranial pressure
SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION (SIADH)
- Excess ADH is released, but not in response to the body’s need for it.
CAUSES
- Trauma, stroke, malignancies, stress
SIGNS AND SYMPTOMS
- Fluid volume overload
- changes in level of consciousness
- weight gain-hypertension, tachycardia, anorexia, hyponatremia
TREATMENT
- Monitor vital signs and neurological status
- Provide intake and output and daily weight
- Monitor fluid and electrolyte balance
- Monitor serum and urine osmolality
- Restrict fluid intake
- Administer diuretics and IV fluids (usually Normal saline or hypertonic saline) as prescribed
- Administer Demeclocycline hydrochloride as prescribed
