Diabetic Ketoacidosis | Made easy | DKA | Causes | Pathophysiology |signs & Symptoms | Management
Diabetes mellitus is a metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion.
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This leads to hyperglycemia, which may result in acute metabolic complications such as
 Diabetic ketoacidosis (DKA) &
 Hyperglycemic hyperosmolar nonketotic syndrome (HHNS).
Diabetic ketoacidosis is characterized by hyperglycemia, ketonemia, and acidemia.DKA is caused by an absence or markedly inadequate amount of insulin.
Causes of Diabetic Ketoacidosis
• Infection: (pneumonia, bacteremia, UTI etc.).drug intoxication
• Side effects of drugs (Steroids),Failed to take insulin
• Vascular occlusion ,Surgical procedures ,Stress
• Pregnancy
Diabetic Ketoacidosis : Pathophysiology
Insulin controls the glucose level in the blood by regulating the production & storage of glucose. In the diabetic state, the cells may stop responding to insulin or the pancreas may stop producing insulin.
Without insulin, the amount of glucose entering the cells is reduced & the liver increases glucose production.----Hyperglycemia-----Osmotic Diuresis-----Dehydration and marked electrolyte loss.
Another effect of insulin deficiency
Breakdown of fat into FFA & glycerol--------FFA converted into Ketone bodies by the liver-------Accumulation of ketone bodies in the circulation
Metabolic acidosis
Clinical Manifestation of Diabetic Ketoacidosis
• Dehydration: Poor skin turgor, Dry mucous membrane
• Electrolyte imbalance
• Acidotic breathing
• Drowsiness, Restlessness, Stupor, Convulsion
• Cardiac irregularities
• Urine output high or low
Diagnostic Evaluation
• History collection
• Physical Examination : Signs of dehydration
• High blood sugar more than 300-400 mg/dl
• Blood Investigation :
Serum electrolytes: Sodium and potassium levels may be low, normal, or high, depending on the amount of water loss (dehydration).
Elevated BUN and creatinine
• ABG : Metabolic acidosis,Respiratory alkalosis
• Urine infections, Pus cells in urine, Ketone bodies in urine
Diabetic Ketoacidosis : Medical Management
• Rehydration:
• Restoring Electrolytes
• Reversing Acidosis
• Blood sugar control & Restoring vital organ control
Diabetic Ketoacidosis : Nursing Management
• Monitor vital signs ,saturation and Pain score
• Monitor electrolyte status as well as blood glucose levels.
• Monitor urine output and mainatin I/O chart.
• Monitor for dysrhythmias indicating abnormal potassium levels.
• Check the conscious level of patient.
• Administer insulin as per the order.
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Yellow pages nursing (YPN) attests to the accuracy of the information contained here but takes no responsibility for how it may apply to an individual patient. The content used in this lesson is used in accordance with Fair Use laws and is intended for educational purposes only.
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