Dka Simulation Essay

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DKA simulation 1. Describe the pathophysiologic changes in DKA. Diabetic ketoacidosis (DKA), is caused by insulin deficiency. Signs of DKA include hyperglycemia, ketosis, acidosis, and dehydration. This condition most likely to occurs in people with type 1 diabetes but may also be seen in type 2 diabetes and also in conditions of severe illness or stress that may cause the pancreas to be unable to meet the extra demand for insulin. Precipitating factors include illness and infection, inadequate insulin dosage, undiagnosed type 1 diabetes, poor self-management, and neglect. 2. What are the commonly seen blood glucose levels? Greater than 250 mg/dL(13.9 mmol/L). 3. What fluid and electrolyte disturbances commonly occur and why? Severe hyponatremia, depletion of potassium chloride, magnesium and phosphate. Extra glucose cannot be used because of insulin deficiency and and blood glucose level rises, which contributes to further, adding to the osmotic diuresis. 4. What acid-based disturbances commonly occur and why? Arterial blood pH less than 7.30, serum bicarbonate level less than 15 mEq/L (15 mmol/L), and moderate-large ketones in the urine or blood ketones. 5. Describe the medical management and nursing management of a patient in DKA? a) Monitor the administration of IV fluids to correct dehydration, b) Give insulin therapy to reduce blood glucose and serum acetone, and c) Electrolytes are given to correct electrolyte imbalance. d) Assess renal status and the cardiopulmonary status related to hydration and electrolyte levels. e) Monitor the level of consciousness/mental status f) Monitor the signs of potassium imbalance resulting from hypoinsulinemia and osmotic diuresis. g) Cardiac monitoring on the ECG is done to aid in detecting hyperkalemia and hypokalemia because characteristic changes indicating potassium excess or deficit are

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