Diabetes Ketoacidosis ( Dka )

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Diabetes ketoacidosis (DKA) primarily occurs in type 1 diabetes which is characterised by hyperglycaemia, polyuria, polydipsia, hyperventilation and dehydration (Mellitus, 2005). DKA is a metabolic disorder characterized by long-lasting hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from deficiencies in insulin secretion, action or both (Wolfsdorf et al., 2007). In diabetes type 1, there is a absence of insulin that is needed for glucose to enter a cell to undergo glycolysis. With insulin no longer present, the process of beta oxidation of fatty acids from the adipose tissue starts and converts the fatty acids into the ketones acetoacetate and b-hydroxybutyrate (Tidy, 2016). However, ketones are…show more content…
Since the body is unable to use the glucose which is present, the blood sugar levels increase. The kidney will start to filter the glucose into the urine to lower the blood sugar levels. Glucose however also pulls along water and solutes with it into the urine, this event is called osmotic diuresis (Wolfsdorf et al., 2007). Mrs DCK’s severity of dehydration must be well managed. Physical examination of her body can tell if she is dehydrated, such as sunken eyes, absent of tears, weak pulses and dry mucus membranes. This can be done with the use of intravenous fluids. As Mrs DCK has a history of high blood pressure and assuming her systolic blood pressure is above 90 mmHg, it is recommended to give 1000mL of NaCl 0.9% IV over the course of 60 minutes. For the continuous use of IV she should be given 1000mL NaCl 0.9% over the next 2 hours, then another 1000mL of NaCl 0.9% over the following 2 hours and finally 1000mL of NaCl 0.9% over the next 4 hours. Nrs DCK must be monitored carefully while giving her IV as she has decrease renal function (Endocrinology Expert Group, 2014). If she has hypernatremia at any stage, the fluid therapy may be switched to NaCl 0.45% solution. The concentration of β-hydroxybutyrate within the blood, as it is confirmation of ketoacidosis. The correction of hyperglycaemia and the suppression of ketone production can be reduced with insulin therapy. The treatment of
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