Page 304 - 2021 IDMT Digital

DIABETIC KETOACIDOSIS (DKA)
Introduction:
• '.$ LV DQ HPHUJHQW OLIH WKUHDWHQLQJ FRPSOLFDWLRQ RI ERWK W\SH , DQG W\SH ,, GLDEHWHV WKDW
FDQ OHDG WR FRPD DQG GHDWK
• '.$ RFFXUV ZKHQ ERG\ FHOOV DUH XQDEOH WR XVH JOXFRVH IRU HQHUJ\ DQG UHVRUW WR WKH
PHWDEROLVP RI IDW WR FUHDWH HQHUJ\

Subjective:
• 6LJQV DQG 6\PSWRPV
o 7KH 3¶V SRO\XULD SRO\GLSVLD SRO\SKDJLD
o /HWKDUJ\
o &RQIXVLRQ
o $EGRPLQDO SDLQ
• )RFXVHG +LVWRU\
o 5HFHQW LOOQHVV
o :HLJKW ORVV
o +LVWRU\ RI GLDEHWHV ZLWK QRQ-DGKHUHQFH WR PHGLFDWLRQ UHJLPHQ
Objective:
• 3K\VLFDO ([DP
o 9LWDO VLJQV WDFK\FDUGLD K\SRWKHUPLD K\SRWHQVLRQ UDSLG DQG GHHS EUHDWKLQJ
o $OWHUHG PHQWDO VWDWXV
o $FHWRQH ³IUXLW\´ EUHDWK
o $EGRPLQDO H[DP PD\ EH WHQGHU WR SDOSDWLRQ
• 7RROV
o 8$: SRVLWLYH NHWRQHV DQG JOXFRVH LQ XULQH
o )LQJHUVWLFN JOXFRVH PJ GL
Assessment:
• 'LIIHUHQWLDO
o 'UXJ RYHUGRVH FRQVLGHU HQYLURQPHQW H[SRVXUHV
o 3DQFUHDWLWLV 3( ILQGLQJV KLVWRU\ (t2+ XVH
o 6KRFN UHFHQW LOOQHVVHV H[SRVXUHV
o 'LDEHWHV mHOOLWXV QRQ FRPSOLDQFH ZLWK PHGLFDWLRQ regimen
Plan:
• ,PPHGLDWHO\ (9$& RU WUDQVIHU
• ,I XQDEOH WR (9$& RU WUDQIHU
o 6XSSRUWLYH FDUH %/6 $&/6
o ,9 ZLWK IOXLG K\GUDWLRQ; insulin if available and under preceptor guidance
o .HHS SDWLHQW LQ FOLQLF XQGHU VXSHUYLVLRQ XQWLO (9$& RU WUDQVIHU

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