What are the 3 priority goals of management of DKA?
The therapeutic goals of DKA management include optimization of 1) volume status; 2) hyperglycemia and ketoacidosis; 3) electrolyte abnormalities; and 4) potential precipitating factors. The majority of patients with DKA present to the emergency room.
What is the difference between DKA and HSS?
DKA usually evolves rapidly. In HHS, there is little or no ketoacidosis and the serum glucose concentration frequently exceeds 1000 mg/dL. HHS usually evolves over a period of several days. Overlap between DKA and HHS occurs in more than one-third of patients.
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.
How do you manage a patient with diabetic ketoacidosis?
Treatment usually involves:
- Fluid replacement. You’ll receive fluids — either by mouth or through a vein — until you’re rehydrated.
- Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride.
- Insulin therapy.
Why is anion gap high in DKA?
In DKA, bicarbonate is replaced by β-hydroxybutyric acid and acetoacetic acid, so that the sum of bicarbonate and chloride concentrations is reduced and the anion gap is thus increased.
What is anion gap in diabetic ketoacidosis?
Anion Gap. In patients with diabetic ketoacidosis, the anion gap is elevated ([Na + K] – [Cl + HCO3] greater than 10 mEq/L in mild cases and greater than 12 mEq/L in moderate and severe cases).
Can you have DKA and HHS at the same time?
Over 30% of patients have features of both DKA and HHS (16) with most recent evidence confirming that about 1 out of 4 patients will have both conditions at the time of presentation with hyperglycemic crisis (18).