Medical Surgical DKA vs HHS #1

Question

The nurse is caring for a client just admitted to the intensive care unit for diabetic ketoacidosis (DKA). Which three priority treatments are critical during diabetic ketoacidosis?

Answers

  1. Potassium replacement, insulin replacement, amiodarone therapy
    • Rationale:

      This answer is not correct because amiodarone is not a standard of treatment since the goal is treating the ketoacidosis and underlying factors related to fluids and insulin. The client has to be treated in the hospital and often in the ICU to address the metabolic acidosis. Priority treatments are fluid replacement, insulin therapy, and electrolyte correction.

  2. Fluid replacement, bicarb replacement, hypertonic saline infusion
    • Rationale:

      This answer is not correct because bicarb is not the standard of care. Although metabolic acidosis is present, correction with fluids and insulin may help correct the acidosis. Priority treatments are fluid replacement, insulin therapy, and electrolyte correction.

  3. Fluid replacement, insulin therapy, and electrolyte correction
    • Rationale:

      This answer is correct because diabetic ketoacidosis (DKA) occurs when ketones or blood acids increase in the bloodstream in response to elevated blood glucose levels and inadequate insulin. DKA can occur due to illness, infection, or insufficient insulin. The client has to be treated in the hospital and often in the ICU to address the metabolic acidosis. Priority treatments are fluid replacement, insulin therapy, and electrolyte correction.

  4. Oral rinses, fluid replacement, bicarb replacement
    • Rationale:

      This answer is not correct because bicarb and oral rinses are not the standard of care. Priority treatments are fluid replacement, insulin therapy, and electrolyte correction and should be instituted immediately.

Overview

Diabetic ketoacidosis (DKA) is a very serious complication of diabetes in which the body produces ketones or blood acids in response to extremely elevated blood glucose levels. The three priority treatments critical during DKA are fluid replacement, insulin therapy, and electrolyte correction.

Explanation

Learning Outcomes

Diabetic ketoacidosis (DKA) is a very serious complication of diabetes mellitus. It occurs when ketones or blood acids increase in the bloodstream in response to elevated blood glucose levels and inadequate insulin. DKA can occur due to illness, infection, or insufficient insulin. The client with DKA has symptoms including extreme thirst, nausea, abdominal cramping, fruity (acetone) breath, frequent urination, and confusion. The blood glucose is extremely elevated and ketones are found in the blood and urine. The client has to be treated in the hospital and often in the ICU to address the metabolic acidosis. Priority treatments are fluid replacement, insulin therapy, and electrolyte correction.

Test Taking Tip

One of the major symptoms of diabetic ketoacidosis (DKA) is Kussmaul respirations. It is a compensatory mechanism for the body to try to correct the acidosis. One way to help you remember is to look at the K in DKA. The K should remind you of Kussmaul respirations!

Video Rationale