diabetic ketoacidosis
•Download as PPTX, PDF•
2 likes•137 views
This document provides guidelines for managing diabetic ketoacidosis (DKA) in intensive care, including correcting fluid loss with intravenous fluids, hyperglycemia with insulin therapy, electrolyte disturbances with potassium replacement, and acid-base balance with sodium bicarbonate if needed. It recommends restoring fluids over 4-6 hours, starting insulin therapy after 1 hour of fluids, maintaining blood glucose decline of 100 mg/dL/hr, and closely monitoring potassium and acid-base levels. Concurrent infections should also be treated with appropriate antibiotics.
Report
Share
Report
Share
Recommended
Principles of acute management of diabetic ketoacidosis
This document provides guidelines for managing diabetic ketoacidosis (DKA) in children. It outlines recommendations for initial fluid bolus and hydration, monitoring of electrolytes and glucose during treatment, use of bicarbonate and insulin therapy, and monitoring of vital signs and lab values. It also describes cerebral edema as a potential complication of DKA and recommends reducing fluid administration rates and using mannitol or hypertonic saline if cerebral edema develops.
Neclex review note Hypokalemia
Hypokalemia, or low potassium levels in the blood, can be caused by drugs, inadequate potassium intake, excessive fluid loss, and other conditions. Signs and symptoms include weak pulses, orthostatic hypotension, and EKG changes such as depression of the ST segment, flat or inverted T waves, and prominent U waves. Nursing interventions include monitoring the patient's condition, administering oral or IV potassium supplements, and educating on foods high in potassium.
Fluid
This document provides information on fluid and electrolyte management in various clinical conditions. It discusses the composition and uses of different intravenous (IV) fluids. It describes types of hyponatremia and emphasizes maintaining euvolemia in conditions like heat stroke and cerebral edema. Key points covered are avoiding hypotonic fluids in stroke and restricting sodium intake in heart failure and hypertension.
Adrenal gland new
The document summarizes key information about the adrenal gland and hormones it produces. It discusses cortisol and aldosterone in depth, including their functions, regulation, and diagnostic tests. It also briefly outlines other hormones produced by the adrenal gland such as androgens and catecholamines, and their normal levels and functions. Various functional tests for evaluating the adrenal gland and its response to ACTH stimulation are summarized, including their medical importance.
Nausea and vomiting by aniqa atta
title: nausea and vomitting
this lecture is about the complication i.e nausea and vomiting occurs during dialysis. this will cover the prevention management and of nausea and vomitting and its causes.
Fluid Therapy in critically ill
A woman with a history of anorexia nervosa and a BMI of 12 kg/m2 was admitted for investigation of weight loss. She deteriorated after initiation of enteral feeding and dextrose infusion, presenting with respiratory failure, hypotension, arrhythmia, and metabolic abnormalities. Given her history of malnutrition and rapid change in nutritional status with feeding, she had likely developed refeeding syndrome, a condition caused by shifts in electrolytes and metabolism during the reintroduction of nutrition to a malnourished patient. Proper identification of high-risk patients and gradual, monitored refeeding is key to preventing refeeding syndrome.
Home Blood Glucose Test Glucometer 5
The document discusses diabetes diagnosis and management. It outlines that a urine glucose test has poor specificity, so a confirmatory blood test is needed if urine is positive. It also describes methods for diagnosing diabetes based on plasma glucose levels from fasting, casual, and oral glucose tolerance tests. The document then covers complications screening and management of diabetes through monitoring of blood glucose, HbA1c, lipids, and complications of eyes, kidneys, nerves, and cardiovascular system.
intravenous fluid
Intravenous fluid therapy involves infusions of crystalloids such as normal saline, dextrose solutions, or Ringer's lactate, as well as colloids like albumin, gelatin, or hydroxyethyl starches. The choice of fluid depends on the indication, whether it be volume resuscitation, maintaining hydration or electrolyte balance, or as a vehicle for intravenous drugs. Care must be taken to avoid complications from large volumes or rapid administration like electrolyte imbalances, edema, or coagulopathies. Preoperative evaluation of a patient's fluid status helps guide appropriate fluid management in the perioperative period.
Recommended
Principles of acute management of diabetic ketoacidosis
This document provides guidelines for managing diabetic ketoacidosis (DKA) in children. It outlines recommendations for initial fluid bolus and hydration, monitoring of electrolytes and glucose during treatment, use of bicarbonate and insulin therapy, and monitoring of vital signs and lab values. It also describes cerebral edema as a potential complication of DKA and recommends reducing fluid administration rates and using mannitol or hypertonic saline if cerebral edema develops.
Neclex review note Hypokalemia
Hypokalemia, or low potassium levels in the blood, can be caused by drugs, inadequate potassium intake, excessive fluid loss, and other conditions. Signs and symptoms include weak pulses, orthostatic hypotension, and EKG changes such as depression of the ST segment, flat or inverted T waves, and prominent U waves. Nursing interventions include monitoring the patient's condition, administering oral or IV potassium supplements, and educating on foods high in potassium.
Fluid
This document provides information on fluid and electrolyte management in various clinical conditions. It discusses the composition and uses of different intravenous (IV) fluids. It describes types of hyponatremia and emphasizes maintaining euvolemia in conditions like heat stroke and cerebral edema. Key points covered are avoiding hypotonic fluids in stroke and restricting sodium intake in heart failure and hypertension.
Adrenal gland new
The document summarizes key information about the adrenal gland and hormones it produces. It discusses cortisol and aldosterone in depth, including their functions, regulation, and diagnostic tests. It also briefly outlines other hormones produced by the adrenal gland such as androgens and catecholamines, and their normal levels and functions. Various functional tests for evaluating the adrenal gland and its response to ACTH stimulation are summarized, including their medical importance.
Nausea and vomiting by aniqa atta
title: nausea and vomitting
this lecture is about the complication i.e nausea and vomiting occurs during dialysis. this will cover the prevention management and of nausea and vomitting and its causes.
Fluid Therapy in critically ill
A woman with a history of anorexia nervosa and a BMI of 12 kg/m2 was admitted for investigation of weight loss. She deteriorated after initiation of enteral feeding and dextrose infusion, presenting with respiratory failure, hypotension, arrhythmia, and metabolic abnormalities. Given her history of malnutrition and rapid change in nutritional status with feeding, she had likely developed refeeding syndrome, a condition caused by shifts in electrolytes and metabolism during the reintroduction of nutrition to a malnourished patient. Proper identification of high-risk patients and gradual, monitored refeeding is key to preventing refeeding syndrome.
Home Blood Glucose Test Glucometer 5
The document discusses diabetes diagnosis and management. It outlines that a urine glucose test has poor specificity, so a confirmatory blood test is needed if urine is positive. It also describes methods for diagnosing diabetes based on plasma glucose levels from fasting, casual, and oral glucose tolerance tests. The document then covers complications screening and management of diabetes through monitoring of blood glucose, HbA1c, lipids, and complications of eyes, kidneys, nerves, and cardiovascular system.
intravenous fluid
Intravenous fluid therapy involves infusions of crystalloids such as normal saline, dextrose solutions, or Ringer's lactate, as well as colloids like albumin, gelatin, or hydroxyethyl starches. The choice of fluid depends on the indication, whether it be volume resuscitation, maintaining hydration or electrolyte balance, or as a vehicle for intravenous drugs. Care must be taken to avoid complications from large volumes or rapid administration like electrolyte imbalances, edema, or coagulopathies. Preoperative evaluation of a patient's fluid status helps guide appropriate fluid management in the perioperative period.
Fluid therapy in pediatrics
This document provides information on fluid and electrolyte therapy. It discusses indications for IV fluid therapy including severe dehydration. It describes the two components of fluid therapy as maintenance therapy to replace normal losses and replacement therapy to correct existing deficits. The document gives guidelines for calculating maintenance fluid requirements based on body weight and additional fluid needs for conditions like fever. It also provides guidance on calculating and correcting water and electrolyte deficits. The document discusses various fluid solutions and considerations for fluid management in different clinical scenarios like dehydration, hyponatremia, hypernatremia, and hypokalemia.
@Blood sugar level venipuncture
This document discusses interpreting blood sugar levels and the technique for withdrawing blood from veins. It provides reference values for normal, pre-diabetic, and diabetic levels for random, fasting, and postprandial blood sugar tests. It also discusses hemoglobin A1c tests and glucose tolerance tests. The second part describes the proper technique for withdrawing blood from veins, including identifying the vein, gathering supplies, applying a tourniquet, inserting the needle at a 15-30 degree angle, and applying pressure after removing the needle.
Fluid management in the paediatric patient anaesthetist consideration...
This document discusses fluid management in paediatric patients. It covers water physiology and fluid compartments in the body. Fluid volumes change with age from premature neonates to adults. Daily fluid losses are outlined. Methods for determining fluid requirements and correcting dehydration are presented. Intraoperative fluid replacement depends on the type and severity of surgery. Blood loss and transfusion thresholds are addressed. Selection of intravenous fluids must be tailored to the individual patient's needs.
Iv nitro presentation
The document discusses SCAPE, which stands for sympathetic crashing acute pulmonary edema. It is a diagnosis of abrupt onset of shortness of breath, respiratory distress, restlessness, diaphoresis, hypertension, and hypoxia caused by left ventricular dysfunction leading to increased pulmonary capillary permeability and fluid overload. Current treatments discussed are continuous positive airway pressure (CPAP), nitroglycerin administered sublingually or intravenously, and an intravenous nitroglycerin protocol based on systolic blood pressure.
Diabetic Ketoacidosis
This document provides an overview of diabetic ketoacidosis (DKA) including its pathophysiology, diagnosis, treatment, and complications. It then presents a case study of an 18-year-old female patient presenting with DKA symptoms including abdominal pain and vomiting. The patient's lab results indicate metabolic acidosis and ketosis. The document outlines her recommended treatment including IV fluids, insulin, antibiotics, and electrolyte replacement. It also discusses monitoring her response to therapy and educating her and her family about diabetes management and prevention of future DKA episodes.
Chapter 11 Presentation
This document summarizes hyperglycemia and hypoglycemia, two conditions related to blood sugar levels. Hyperglycemia is defined as having excessively high blood sugar levels over 200mg/dL and can cause excessive thirst, urination, and hunger. Treatment may include exercise, diet changes, or insulin medication. Hypoglycemia is defined as having low blood sugar levels under 60mg/dL and can cause symptoms like shakiness, sweating, and confusion. Treatment for hypoglycemia includes consuming sugar or glucagon to stimulate glucose release into the blood.
Furosemide DRUG PROFILE
Furosemide is a loop diuretic that works by inhibiting sodium and chloride reabsorption in the ascending limb of the loop of Henle, leading to increased excretion of sodium, chloride, calcium, and water from the body. It is commonly used to treat fluid retention, edema, and hypertension. Some key points are that it acts more rapidly than thiazide diuretics, can be used in patients with renal impairment, and causes diuretic effects within 0.5-1 hour when taken orally. Common side effects include hypokalemia, hypomagnesaemia, and ototoxicity when combined with other drugs.
IV FLUID MANAGEMENT/ FLUID THERAPY
This document provides information on fluid therapy. It begins by classifying fluids as crystalloids or colloids based on their ability to diffuse. Crystalloids like normal saline (NS) diffuse freely while colloids do not pass as readily. NS is commonly used but can cause acidosis due to its chloride content. Ringer's lactate is more physiological with an electrolyte profile similar to plasma. Dextrose solutions like 5% dextrose provide calories but can increase lactate levels in critical illness. The document discusses the properties, indications, and limitations of various intravenous fluids.
Fluids and Electrolytes in Infants and Children
This document discusses fluid and electrolyte balance in infants and children. It covers normal fluid regulation, increased and decreased fluid needs, signs of dehydration and fluid overload, diagnostic tests including electrolyte levels, treatment for dehydration including oral and IV rehydration, and acid-base imbalances including causes and management of respiratory and metabolic acidosis and alkalosis.
IV FLUID MANAGEMENT IN SURGICAL PATIENTS.
IV FLUID MANAGEMENT IN SURGICAL PATIENTS.
-Dr. Subhajit Debnath.
Dengue
There are two main types of intravenous fluids - crystalloids and colloids. Crystalloids are aqueous solutions of mineral salts that increase both intravascular and interstitial fluid volume, while colloids preserve intravascular volume but can be more expensive. Normal saline and Ringer's lactate are commonly used crystalloid solutions, while hydroxyethyl starch is a frequently used colloid. Care must be taken to avoid fluid overload, which can lead to pulmonary edema and other complications in severe dengue cases requiring large volume resuscitation. The type of intravenous fluid used is less important than carefully monitoring volume status and administering just enough fluid to maintain circulation.
Fluids & Electrolytes
The document discusses fluid and electrolyte therapy under the supervision of Dr. Ashraf Thabet. It covers topics like total body water, water sources and losses, electrolyte metabolism, types of fluids including crystalloids and colloids, and guidelines for perioperative fluid therapy. Clinical signs and treatment of various fluid and electrolyte imbalances like hyponatremia, hypernatremia, hypokalemia, and hypocalcemia are also summarized.
Fluid and electrolyte slideshare
This document discusses fluid and electrolyte balance. It begins by outlining the objectives of reviewing normal fluid composition, crystalloid and colloid solutions, and perioperative fluid management. It then discusses the fluid compartments in the body, fluid homeostasis, types of fluids including crystalloids, colloids, and blood products. It provides details on specific crystalloid and colloid solutions, perioperative fluid therapy including maintenance requirements and replacing losses. It concludes by discussing clinical evaluation of fluid replacement and management of common electrolyte imbalances such as sodium, potassium, and calcium.
13 Fluid Therapy
The document discusses fluid therapy for acute diarrhea and dehydration in children. It covers the pathophysiology of dehydration, clinical signs, diagnosis, electrolyte disturbances, and treatment approaches including oral rehydration solutions and intravenous fluid therapy. Treatment involves correcting water and electrolyte deficits in a stepwise manner, first expanding blood volume and then replenishing and maintaining fluids based on the degree of dehydration.
Different Type of Intravenous fluids
1) IV fluids are used to restore or maintain fluid and electrolyte balance when the oral route is not possible. They are categorized based on their tonicity as isotonic, hypotonic, or hypertonic.
2) Isotonic fluids like normal saline and lactated ringer's solution maintain the same osmotic pressure as blood plasma. Hypotonic fluids like D5W cause fluid to shift into cells while hypertonic fluids like 3% saline cause fluid to shift out of cells.
3) The appropriate fluid must be selected based on the patient's condition and fluid needs to avoid complications like fluid overload, electrolyte imbalances, and cell swelling or shrinkage. Close monitoring is needed
Intravenous fluids and parenteral nutritions slides Dr sarfaraz
The document discusses various types of parenteral fluids used in intravenous therapy, including crystalloids, colloids, blood products, and miscellaneous fluids. It provides details on the composition, properties, indications, and considerations of commonly used crystalloids like saline, dextrose, lactated ringer's, sodium bicarbonate and colloids like albumin, hetastarch, dextran, and mannitol. Whole blood components like packed red blood cells and fresh frozen plasma are also summarized.
Crystalloid fluid therapy
Its a recent review about crystalloid fluid therapy based on review article critical care 2016 ,march.
Hba1 c
This document discusses HbA1c, a blood test that measures average blood glucose levels over the past 3 months. It provides background on what HbA1c is, how it forms, its historical context, reference values, estimation methods, and how lowering HbA1c reduces risks of diabetes complications based on studies. It also discusses correlations between HbA1c, mean plasma glucose, advantages of HbA1c as a long-term marker of diabetes control, and limitations such as not being useful for acute decisions or situations that impact HbA1c like anemia.
Fluid therapy in animals
Fluid therapy in animalsObli Rajendran VinodhKumar, ICAR- Indian Veterinary Research Institute, Bareilly
This document discusses fluid therapy in animals. It begins by describing the distribution of water in the body and the composition of intracellular and extracellular fluids. It then discusses three types of fluid disturbances: changes in volume, content, and distribution. The document outlines different types of fluid therapy including replacement, adjunctive, and supportive therapies. It provides details on routes of fluid administration and indications for intravenous fluids. Throughout, it discusses evaluating and monitoring fluid therapy, diagnosing and treating dehydration, and complications of intravenous fluids.Fluid therapy
This document discusses pediatric fluid therapy and body fluid compartments. It begins by describing the different fluid compartments in the body, including total body water, extracellular fluid, and intracellular fluid. It then focuses on neonatal fluid management, noting that extracellular fluid is initially greater than intracellular fluid at birth, and describing appropriate intravenous fluid volumes for neonates. The document also discusses fluid requirements in children, evaluation of intravascular volume, choice of fluid types including crystalloids, colloids, and blood products, and provides guidelines for fluid resuscitation in dehydrated children.
DKA clinical teach.pptx specially for nursing students
Diabetes ketoacidosis is a complications of type 1 diabetes mellitus
Diabetic Ketoacidosis Management Protocol _Internal Medicine KHC
Diabetic Ketoacidosis Management Protocol _Internal Medicine KHCDr. Lazaro Nicanor Rodriguez Gonzalez
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes resulting from severe insulin deficiency and manifested by dehydration, hyperglycemia, ketonemia, and metabolic acidosis. Treatment involves fluid replacement, insulin therapy, electrolyte replacement, and treating any precipitating infections. Patients must be closely monitored for changes in vital signs, glucose and electrolyte levels, pH, and ketones until stabilized.More Related Content
What's hot
Fluid therapy in pediatrics
This document provides information on fluid and electrolyte therapy. It discusses indications for IV fluid therapy including severe dehydration. It describes the two components of fluid therapy as maintenance therapy to replace normal losses and replacement therapy to correct existing deficits. The document gives guidelines for calculating maintenance fluid requirements based on body weight and additional fluid needs for conditions like fever. It also provides guidance on calculating and correcting water and electrolyte deficits. The document discusses various fluid solutions and considerations for fluid management in different clinical scenarios like dehydration, hyponatremia, hypernatremia, and hypokalemia.
@Blood sugar level venipuncture
This document discusses interpreting blood sugar levels and the technique for withdrawing blood from veins. It provides reference values for normal, pre-diabetic, and diabetic levels for random, fasting, and postprandial blood sugar tests. It also discusses hemoglobin A1c tests and glucose tolerance tests. The second part describes the proper technique for withdrawing blood from veins, including identifying the vein, gathering supplies, applying a tourniquet, inserting the needle at a 15-30 degree angle, and applying pressure after removing the needle.
Fluid management in the paediatric patient anaesthetist consideration...
This document discusses fluid management in paediatric patients. It covers water physiology and fluid compartments in the body. Fluid volumes change with age from premature neonates to adults. Daily fluid losses are outlined. Methods for determining fluid requirements and correcting dehydration are presented. Intraoperative fluid replacement depends on the type and severity of surgery. Blood loss and transfusion thresholds are addressed. Selection of intravenous fluids must be tailored to the individual patient's needs.
Iv nitro presentation
The document discusses SCAPE, which stands for sympathetic crashing acute pulmonary edema. It is a diagnosis of abrupt onset of shortness of breath, respiratory distress, restlessness, diaphoresis, hypertension, and hypoxia caused by left ventricular dysfunction leading to increased pulmonary capillary permeability and fluid overload. Current treatments discussed are continuous positive airway pressure (CPAP), nitroglycerin administered sublingually or intravenously, and an intravenous nitroglycerin protocol based on systolic blood pressure.
Diabetic Ketoacidosis
This document provides an overview of diabetic ketoacidosis (DKA) including its pathophysiology, diagnosis, treatment, and complications. It then presents a case study of an 18-year-old female patient presenting with DKA symptoms including abdominal pain and vomiting. The patient's lab results indicate metabolic acidosis and ketosis. The document outlines her recommended treatment including IV fluids, insulin, antibiotics, and electrolyte replacement. It also discusses monitoring her response to therapy and educating her and her family about diabetes management and prevention of future DKA episodes.
Chapter 11 Presentation
This document summarizes hyperglycemia and hypoglycemia, two conditions related to blood sugar levels. Hyperglycemia is defined as having excessively high blood sugar levels over 200mg/dL and can cause excessive thirst, urination, and hunger. Treatment may include exercise, diet changes, or insulin medication. Hypoglycemia is defined as having low blood sugar levels under 60mg/dL and can cause symptoms like shakiness, sweating, and confusion. Treatment for hypoglycemia includes consuming sugar or glucagon to stimulate glucose release into the blood.
Furosemide DRUG PROFILE
Furosemide is a loop diuretic that works by inhibiting sodium and chloride reabsorption in the ascending limb of the loop of Henle, leading to increased excretion of sodium, chloride, calcium, and water from the body. It is commonly used to treat fluid retention, edema, and hypertension. Some key points are that it acts more rapidly than thiazide diuretics, can be used in patients with renal impairment, and causes diuretic effects within 0.5-1 hour when taken orally. Common side effects include hypokalemia, hypomagnesaemia, and ototoxicity when combined with other drugs.
IV FLUID MANAGEMENT/ FLUID THERAPY
This document provides information on fluid therapy. It begins by classifying fluids as crystalloids or colloids based on their ability to diffuse. Crystalloids like normal saline (NS) diffuse freely while colloids do not pass as readily. NS is commonly used but can cause acidosis due to its chloride content. Ringer's lactate is more physiological with an electrolyte profile similar to plasma. Dextrose solutions like 5% dextrose provide calories but can increase lactate levels in critical illness. The document discusses the properties, indications, and limitations of various intravenous fluids.
Fluids and Electrolytes in Infants and Children
This document discusses fluid and electrolyte balance in infants and children. It covers normal fluid regulation, increased and decreased fluid needs, signs of dehydration and fluid overload, diagnostic tests including electrolyte levels, treatment for dehydration including oral and IV rehydration, and acid-base imbalances including causes and management of respiratory and metabolic acidosis and alkalosis.
IV FLUID MANAGEMENT IN SURGICAL PATIENTS.
IV FLUID MANAGEMENT IN SURGICAL PATIENTS.
-Dr. Subhajit Debnath.
Dengue
There are two main types of intravenous fluids - crystalloids and colloids. Crystalloids are aqueous solutions of mineral salts that increase both intravascular and interstitial fluid volume, while colloids preserve intravascular volume but can be more expensive. Normal saline and Ringer's lactate are commonly used crystalloid solutions, while hydroxyethyl starch is a frequently used colloid. Care must be taken to avoid fluid overload, which can lead to pulmonary edema and other complications in severe dengue cases requiring large volume resuscitation. The type of intravenous fluid used is less important than carefully monitoring volume status and administering just enough fluid to maintain circulation.
Fluids & Electrolytes
The document discusses fluid and electrolyte therapy under the supervision of Dr. Ashraf Thabet. It covers topics like total body water, water sources and losses, electrolyte metabolism, types of fluids including crystalloids and colloids, and guidelines for perioperative fluid therapy. Clinical signs and treatment of various fluid and electrolyte imbalances like hyponatremia, hypernatremia, hypokalemia, and hypocalcemia are also summarized.
Fluid and electrolyte slideshare
This document discusses fluid and electrolyte balance. It begins by outlining the objectives of reviewing normal fluid composition, crystalloid and colloid solutions, and perioperative fluid management. It then discusses the fluid compartments in the body, fluid homeostasis, types of fluids including crystalloids, colloids, and blood products. It provides details on specific crystalloid and colloid solutions, perioperative fluid therapy including maintenance requirements and replacing losses. It concludes by discussing clinical evaluation of fluid replacement and management of common electrolyte imbalances such as sodium, potassium, and calcium.
13 Fluid Therapy
The document discusses fluid therapy for acute diarrhea and dehydration in children. It covers the pathophysiology of dehydration, clinical signs, diagnosis, electrolyte disturbances, and treatment approaches including oral rehydration solutions and intravenous fluid therapy. Treatment involves correcting water and electrolyte deficits in a stepwise manner, first expanding blood volume and then replenishing and maintaining fluids based on the degree of dehydration.
Different Type of Intravenous fluids
1) IV fluids are used to restore or maintain fluid and electrolyte balance when the oral route is not possible. They are categorized based on their tonicity as isotonic, hypotonic, or hypertonic.
2) Isotonic fluids like normal saline and lactated ringer's solution maintain the same osmotic pressure as blood plasma. Hypotonic fluids like D5W cause fluid to shift into cells while hypertonic fluids like 3% saline cause fluid to shift out of cells.
3) The appropriate fluid must be selected based on the patient's condition and fluid needs to avoid complications like fluid overload, electrolyte imbalances, and cell swelling or shrinkage. Close monitoring is needed
Intravenous fluids and parenteral nutritions slides Dr sarfaraz
The document discusses various types of parenteral fluids used in intravenous therapy, including crystalloids, colloids, blood products, and miscellaneous fluids. It provides details on the composition, properties, indications, and considerations of commonly used crystalloids like saline, dextrose, lactated ringer's, sodium bicarbonate and colloids like albumin, hetastarch, dextran, and mannitol. Whole blood components like packed red blood cells and fresh frozen plasma are also summarized.
Crystalloid fluid therapy
Its a recent review about crystalloid fluid therapy based on review article critical care 2016 ,march.
Hba1 c
This document discusses HbA1c, a blood test that measures average blood glucose levels over the past 3 months. It provides background on what HbA1c is, how it forms, its historical context, reference values, estimation methods, and how lowering HbA1c reduces risks of diabetes complications based on studies. It also discusses correlations between HbA1c, mean plasma glucose, advantages of HbA1c as a long-term marker of diabetes control, and limitations such as not being useful for acute decisions or situations that impact HbA1c like anemia.
Fluid therapy in animals
Fluid therapy in animalsObli Rajendran VinodhKumar, ICAR- Indian Veterinary Research Institute, Bareilly
This document discusses fluid therapy in animals. It begins by describing the distribution of water in the body and the composition of intracellular and extracellular fluids. It then discusses three types of fluid disturbances: changes in volume, content, and distribution. The document outlines different types of fluid therapy including replacement, adjunctive, and supportive therapies. It provides details on routes of fluid administration and indications for intravenous fluids. Throughout, it discusses evaluating and monitoring fluid therapy, diagnosing and treating dehydration, and complications of intravenous fluids.Fluid therapy
This document discusses pediatric fluid therapy and body fluid compartments. It begins by describing the different fluid compartments in the body, including total body water, extracellular fluid, and intracellular fluid. It then focuses on neonatal fluid management, noting that extracellular fluid is initially greater than intracellular fluid at birth, and describing appropriate intravenous fluid volumes for neonates. The document also discusses fluid requirements in children, evaluation of intravascular volume, choice of fluid types including crystalloids, colloids, and blood products, and provides guidelines for fluid resuscitation in dehydrated children.
What's hot (20)
Fluid management in the paediatric patient anaesthetist consideration...
Fluid management in the paediatric patient anaesthetist consideration...
Intravenous fluids and parenteral nutritions slides Dr sarfaraz
Intravenous fluids and parenteral nutritions slides Dr sarfaraz
Similar to diabetic ketoacidosis
DKA clinical teach.pptx specially for nursing students
Diabetes ketoacidosis is a complications of type 1 diabetes mellitus
Diabetic Ketoacidosis Management Protocol _Internal Medicine KHC
Diabetic Ketoacidosis Management Protocol _Internal Medicine KHCDr. Lazaro Nicanor Rodriguez Gonzalez
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes resulting from severe insulin deficiency and manifested by dehydration, hyperglycemia, ketonemia, and metabolic acidosis. Treatment involves fluid replacement, insulin therapy, electrolyte replacement, and treating any precipitating infections. Patients must be closely monitored for changes in vital signs, glucose and electrolyte levels, pH, and ketones until stabilized.MANAGEMENT OF dka.pptx
This document provides guidelines for the management of diabetic ketoacidosis (DKA). It defines DKA and classifies its severity. The main goals of treatment are rehydration, electrolyte replacement, and insulin administration to lower blood glucose levels slowly. Treatment involves initial fluid resuscitation followed by intravenous fluids and insulin. Potassium levels must be closely monitored and replaced as needed. Fluids are given over 48 hours and patients transition to subcutaneous insulin before discharge. Complications like cerebral edema are risks that require careful monitoring of fluid, electrolyte and glucose levels during treatment.
Hyperkalemia
This document provides guidelines for the management of hyperkalemia according to NICE guidelines. It defines mild, moderate and severe hyperkalemia based on potassium levels. It describes the causes, signs and symptoms, and appropriate investigations. For severe hyperkalemia when potassium is >6.5 mmol/L or ECG changes are present, the guidelines recommend ECG monitoring, protecting the cardiac membrane with calcium, shifting potassium into cells with insulin/glucose, administering salbutamol via nebulization, stopping further potassium accumulation and considering hemodialysis if levels remain high. For moderate hyperkalemia when potassium is 6.0-6.4 mmol/L and no ECG changes, the guidelines recommend insulin/
Diabetic ketoacidosis
This document describes a case of diabetic ketoacidosis (DKA) in a 32-year-old male patient presenting with vomiting, drowsiness, abdominal pain, fever and cough. On examination, the patient showed signs of dehydration and mild abdominal tenderness. Laboratory findings confirmed hyperglycemia, acidosis, ketonemia and electrolyte abnormalities. The patient was diagnosed with DKA and treated with IV fluids, insulin, electrolyte replacement, and antibiotics for the concurrent infection, with the goals of correcting dehydration, hyperglycemia, acidosis and electrolyte disturbances. Complications of DKA and the importance of patient education are also discussed.
Hyperglycemic Crises
Hyperglycemic crises like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are medical emergencies caused by low insulin levels and high counterregulatory hormones. DKA is diagnosed when blood glucose is over 250 mg/dl, pH is below 7.3, and bicarbonate is under 18; HHS when glucose is over 600 mg/dl and pH is above 7.3. Treatment involves fluid resuscitation, insulin therapy to lower blood glucose, electrolyte replacement, and identifying/treating precipitating causes. Careful monitoring of glucose, electrolytes, pH and clinical status is required for resolution. Complications can include hypogly
DKA.pptx
DKA is an acute complication of diabetes characterized by hyperglycemia, ketone body formation and metabolic acidosis. It is caused by severe insulin deficiency together with elevated stress hormones, leading to increased glucose production and impaired glucose uptake. This causes lipolysis, ketone body production and metabolic acidosis. Treatment involves IV fluids, IV insulin, IV potassium and bicarbonate to correct dehydration, acidosis and electrolyte imbalances. Complications can include cerebral edema, respiratory failure and cardiac issues if treatment is not properly administered.
Dka mgt
The document outlines guidelines for managing diabetic ketoacidosis (DKA). It begins with objectives and an outline, then defines DKA and describes its pathogenesis. Treatment involves fluid resuscitation, insulin therapy to control hyperglycemia, electrolyte replacement, and treating any precipitating factors. The goals are to rehydrate the patient and resolve acidosis and ketosis within 24-36 hours while avoiding too rapid glucose correction. Close monitoring of glucose and electrolytes is required.
Diabetic ketoacidosis
This document describes the case of an 18-year-old female patient presenting with symptoms of diabetic ketoacidosis (DKA) including tiredness, weight loss, thirst, glycosuria, low blood pressure, fast pulse, cold extremities, and acetone breath. Laboratory investigations found high blood glucose, low bicarbonate, high anion gap metabolic acidosis, and ketones in the blood and urine. The case report discusses the pathophysiology of DKA in terms of hyperglycemia, ketosis, and metabolic acidosis. It also outlines the management of DKA, including gradual rehydration, insulin therapy, electrolyte replacement, and monitoring for complications such as cerebral edema.
Diabetic Emergencies
Academic discussion/ Lecture class for 5th year MBBS students on Diabetic Emergencies, types, their sign-symptoms and managements. Most of the Data was taken from Davidson's Principles and Practice of Medicine.
Diabetes ketoacidosis
The document discusses diabetic ketoacidosis (DKA), providing definitions, pathophysiology, precipitating events, symptoms, diagnosis, and treatment. DKA is defined as hyperglycemia, ketosis, and acidemia. It results from insulin deficiency leading to lipolysis, ketogenesis, and hyperglycemia. Common causes include infection, inadequate insulin, drugs like cocaine, and pregnancy. Treatment involves fluid resuscitation, insulin therapy to lower glucose levels to 140-180 mg/dL, electrolyte replacement, and treating the underlying precipitant once the patient is stabilized. Potassium levels require close monitoring during treatment.
ACTEP2014: What's new in endocrine emergency
This document summarizes guidelines for treatment of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) from the American Diabetes Association (ADA) and Joint British Diabetes Societies Inpatient (JBDS IP). Key points include:
1) Bedside beta-hydroxybutyrate testing is now the best way to monitor treatment response in DKA.
2) For DKA, guidelines recommend fixed rate insulin infusion of 0.1 unit/kg/hr without a priming dose and adjustments to meet metabolic targets.
3) For HHS, the goal of initial therapy is to expand intravascular volume and restore perfusion by replacing approximately 50
DKA and HHS
Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two serious complications of diabetes that represent extremes of the hyperglycemia spectrum. DKA is characterized by hyperglycemia, metabolic acidosis, and ketonemia while HHS features very high blood glucose over 600 mg/dL without significant ketoacidosis. Both require intravenous fluid replacement and insulin therapy. Resolution of DKA requires normalization of acidosis markers and blood glucose under 200 mg/dL while HHS resolution involves blood glucose under 250-300 mg/dL and mental alertness with plasma osmolality under 315 mosmol/kg.
Diabetic Ketoacidosis Management Guideline.pptx
This document provides guidelines for the management of diabetic ketoacidosis (DKA) in adults. DKA is characterized by high blood glucose, ketone levels, and metabolic acidosis. The main goals of treatment are to correct dehydration, lower blood glucose and ketone levels, and treat any underlying causes. Treatment involves intravenous fluid replacement, insulin therapy via continuous intravenous infusion, electrolyte replacement, and monitoring until resolution of DKA. Guidelines are provided for fluid administration, insulin dosing, treatment targets, and conversion to subcutaneous insulin when stable. Special considerations are discussed for certain patient groups.
Dka+hhs
discussion of acute complication of DM.
diabetic ketoacidosis and hyperglycemic hyperosmolar state.
electrolyte.pdf
1. Hypokalemia is defined as a serum potassium level below 3.5 mEq/L. It can cause weakness, paralysis, and ECG changes. Treatment involves oral or IV potassium supplementation as well as treating the underlying cause.
2. Hyperkalemia is defined as a serum potassium above 5.5 mEq/L. It can cause muscle weakness, arrhythmias, and ECG changes like peaked T waves. Treatment focuses on stabilizing the heart with calcium, driving potassium into cells with insulin/glucose or beta-agonists, and removing potassium from the body with cation exchange resins or dialysis.
3. Severe cases may require higher doses administered more quickly via
potassiumimbalanceandmanagement-171224181212.pdf
The document discusses potassium imbalance and its management. It provides reference ranges for normal serum electrolyte levels including potassium. It then describes causes, classifications, signs and symptoms of hyperkalemia. Treatment for hyperkalemia involves stabilizing cell membranes, shifting potassium into cells, and removing potassium from the body. Management differs based on severity, with severe hyperkalemia over 6.5 mmol/L treated as a medical emergency. Hypokalemia is also discussed, outlining its causes, signs, and initial treatment involving potassium replacement and identifying its cause.
Potassium imbalance and management
This document discusses potassium imbalance and its management. It provides reference ranges for normal serum electrolyte levels including potassium. It then discusses causes, classifications, signs, and treatments for both hyperkalemia and hypokalemia. For hyperkalemia, it outlines approaches for managing severe cases including using calcium, insulin, beta-agonists, and dialysis. For hypokalemia it discusses causes like drugs and investigations to identify the cause before outlining oral and IV supplementation approaches.
DKA clinical presentation of diabetic keto acidosis
DKA is a life-threatening complication of diabetes caused by lack of insulin and high blood glucose levels. It is characterized by hyperglycemia over 250 mg/dL, metabolic acidosis with blood pH below 7.3 and bicarbonate below 15 mEq/L, and ketones in the blood. Treatment involves rapid fluid resuscitation, insulin therapy to lower blood glucose levels, electrolyte replacement, and treating any underlying infections. The goals are to correct dehydration, lower blood glucose, reverse acidosis, and replenish electrolytes like potassium. Management involves IV fluids, IV or subcutaneous insulin, monitoring labs closely and watching for complications.
Diabetic ketoacidosis in children
This is the fifth lecture. it is based on guidelines by NHS UK. the guidelines based are freely available in internet. the source and the used literature are trusted and accurate. i hope this level of a knowledge about the management side of the DKA touches the all areas of patient survival. patho-physiology not discussed here but will be discussed in another lecture in details. to a intern and final year MBBS students or ERPM students must process a level of knowledge described by the lecture. definitely more you read more knowledge you get. get the idea in the lecture and principles of management. so you will be much accurate in a ward. always take superior advice while managing emergencies.
Similar to diabetic ketoacidosis (20)
DKA clinical teach.pptx specially for nursing students
DKA clinical teach.pptx specially for nursing students
Diabetic Ketoacidosis Management Protocol _Internal Medicine KHC
Diabetic Ketoacidosis Management Protocol _Internal Medicine KHC
DKA clinical presentation of diabetic keto acidosis
DKA clinical presentation of diabetic keto acidosis
More from Tarek Sallam
Brucellosis
Brucellosis is caused by bacteria of the genus Brucella and is a worldwide zoonosis. It is transmitted primarily through contact with infected animals or animal products. The most common species that infect humans are B. melitensis, B. abortus, B. suis, and recently B. pinnipediae and B. cetaceae. Brucellosis is characterized by nonspecific flu-like symptoms such as fever, fatigue, and joint pain. It can become a chronic debilitating disease if left untreated. Diagnosis involves blood cultures, serology, or PCR. Treatment consists of a combination of doxycycline and rifampin or streptomycin for 6 weeks.
Health care etics 7
This chapter discusses ethics related to dealing with life-threatening and incurable diseases. It addresses issues such as a patient's right to refuse treatment, stopping medical treatment, cardiopulmonary resuscitation (CPR), and conditions of prolonged or terminal coma. Key points include that patients have the right to refuse treatment if fully informed, treatment should not be stopped if the patient and family disagree, CPR may not be useful in late-stage or incurable diseases, and patients in irreversible coma should continue receiving care without complicated equipment. All decisions must be well-documented and communicated to the treatment team and patient's family.
Health care ethics 6
This document discusses ethics related to conducting biomedical research. It outlines several key principles:
1) Biomedical research on humans must follow relevant laws, comply with religious principles, have important objectives where expected benefits outweigh risks, and respect patients' dignity, privacy, and consent.
2) Research interventions on humans should first be tested on animals by qualified researchers.
3) Research on animals must have an important purpose and not cause unnecessary pain or be done for trivial reasons.
4) Researchers must disclose funding sources, conflicts of interest, and results honestly.
Health care ethics 5
This document discusses several ethics topics related to financial affairs in healthcare. It addresses ethics around (A) healthcare practitioner fees, (B) practicing in the private sector, (C) advertisements and publicity, (D) participation in media, (E) gifts and benefits, (F) relationships with pharmaceutical companies, and (G) insurance. The key points are that healthcare practitioners should determine fair fees, avoid conflicts of interest, prioritize patient interests over financial gains, and adhere to standards regarding gifts, advertising, and relationships with outside companies.
Health care ethics 4
This document discusses several topics related to health care ethics:
1. Exposing private body parts is only permitted if necessary and with same-sex providers for limited time. Training is not allowed.
2. Abortion is only permitted if the pregnant woman's life is threatened and proven necessary by a medical committee if less than 4 months pregnant.
3. HCPs must maintain professional relationships with the opposite sex and avoid private details or abuse of trust.
4. Teaching and learning on patients requires informed consent and respect for privacy, dignity, and confidentiality. Excessive exams are avoided.
5. Medical records, certificates, reports and prescriptions must be handled according to professional standards to ensure accuracy
Health care ethics 3
The document outlines the duties of healthcare practitioners towards their community, professional colleagues, themselves, and their profession. It discusses roles like being a role model, recognizing important health factors, practicing with high standards of knowledge and ethics, contributing to community programs, providing health education, and interacting professionally with media. Practitioners must also respect colleagues, maintain standards, protect patient confidence, and avoid abusive or unethical behaviors that insult the profession.
Health care ethics 2
This document outlines the duties of healthcare practitioners towards patients, including: providing good treatment by listening to patients and showing respect; achieving the patient's interests and guarding their rights by limiting unnecessary procedures and informing them of treatment options; obtaining valid consent by ensuring the patient understands risks and can consent voluntarily; reassuring patients by addressing psychological needs and breaking bad news sensitively; maintaining patient confidentiality with exceptions to protect others or report crimes; and obtaining proper consent before photographing or recording patients.
Health care ethics 1
This document discusses medical profession ethics and regulations. It defines professional ethics as guidelines for proper conduct in healthcare, and professional regulations as rules that govern healthcare practice and can have legal consequences. Regulations should be based on ethics. The document outlines characteristics of healthcare practitioners and their honorable role in preserving life while maintaining patient privacy. Sources of healthcare ethics are discussed as religions, social agreements, culture, and research. Senior healthcare practitioners are described as role models who can inspire ethical conduct in younger generations through sharing experiences.
Acute bacterial meningitis
This document discusses meningitis, including risk factors, causes, symptoms, physical exam findings, complications, and diagnosis. The main points are:
- Meningitis is an infection of the meninges that can be caused by bacteria, viruses, fungi or other organisms. Common bacterial causes include pneumococcus, meningococcus, and H. influenzae.
- Risk factors include extremes of age, immunocompromise, head injuries, co-existing infections like sinusitis. Symptoms include headache, fever, neck stiffness but presentation can vary, especially in young, old, or immunocompromised patients.
- Diagnosis involves lumbar puncture of CSF for analysis of white cells, glucose, proteins
Guideline for the Empirical Treatment of Infections in Adults
This document provides guidelines for the empirical treatment of infections in adults. It outlines considerations for when antibiotics should be prescribed and recommendations for initial antibiotic regimens for common infections including sepsis, central nervous system infections, urinary tract infections, infective endocarditis, and respiratory tract infections. The guidelines recommend broad-spectrum antibiotics be initiated rapidly for sepsis and narrowed based on culture results. It emphasizes the importance of documentation, review, and switching to oral antibiotics when possible.
monitoring and evaluation
The document discusses monitoring and evaluation (M&E) of health programs, defining monitoring as the routine collection of data to track progress towards objectives, while evaluation assesses the impact of a program by measuring outcomes at baseline and endline using a control group. It provides guidance on developing M&E plans, including describing programs and expected outcomes, identifying indicators, data collection sources and schedules, and disseminating findings to inform decision-making.
More from Tarek Sallam (12)
Guideline for the Empirical Treatment of Infections in Adults
Guideline for the Empirical Treatment of Infections in Adults
Recently uploaded
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
MERCURY GROUP.BHMS.MATERIA MEDICA.HOMOEOPATHY
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
DECLARATION OF HELSINKI - History and principles
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
10 Benefits an EPCR Software should Bring to EMS Organizations
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
pathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathology
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Kosmoderma Academy Of Aesthetic Medicine
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS). Parc Taulí. Sabadell
Ketone bodies and metabolism-biochemistry
This slide consists of all the topics of ketone . This can be used for exam purpose for writing about Diabetic keto acidosis etc . Thank you
vonoprazan A novel drug for GERD presentation
Vonoprazan, a new potassium acid channel blocker used in the conditions of GERD and gastric ulcer, duodenal ulcer ....
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
une 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Acute Gout Care & Urate Lowering Therapy .pdf
In this document , the management of acute gout attacks and a description of urate lowering therapy is mentioned.
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Recently uploaded (20)
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
10 Benefits an EPCR Software should Bring to EMS Organizations
10 Benefits an EPCR Software should Bring to EMS Organizations
pathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathology
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
diabetic ketoacidosis
- 1. Col. Dr. Tarek Abdelkader Aboulmagd
- 2. Approach Considerations Managing (DKA) in an intensive care unit during the first 24-48 hours always is advisable. The following must be considered and closely monitored: Correction of fluid loss with intravenous fluids Correction of hyperglycemia with insulin Correction of electrolyte disturbances, particularly potassium loss Correction of acid-base balance Treatment of concurrent infection, if present
- 3. Correction of Fluid Loss Aim: Replace Fluids Electrolyte Dilute Glucose Counter-regulatory Hormones
- 4. Correction of Fluid Loss The recommended schedule for restoring fluids is as follows: 1-3 L during the first hour. 1 L during the second hour. 1 L during the following 2 hours 1 L every 4 hours, depending on the degree of dehydration and CVP readings
- 5. Correction of Fluid Loss When euvolemic, switch to half the isotonic sodium chloride solution avoid hypernatremia
- 6. Correction of Fluid Loss When blood sugar decreases to less than 180 mg/dl Replace isotonic sodium chloride solution with 5-10% dextrose + half isotonic sodium chloride solution.
- 7. Insulin should be started about an hour after IV fluid replacement is started to allow for checking potassium levels more dangerous less effective
- 8. Insulin Therapy • A low-dose insulin regimen is preferable to avoid severe hypoglycemia or hypokalemia. insulin regimen • is used for correction of hyperglycemia. • IV is better than SC. short-acting insulin
- 9. Insulin Therapy Initial pump 0.1 U/kg/h. Mix 24 units of regular insulin in 60 mL of isotonic sodium chloride at a rate of 15 mL/h (6 U/h) until the blood glucose ≤ 180 mg/dL Then the rate of infusion then decreases to 5- 7.5 mL/h (2-3 U/h). until the ketoacidotic state abates
- 10. Insulin Therapy The optimal rate of glucose decline is 100 mg/dL/h. Do not allow the blood glucose level to fall below 200 mg/dL during the first 4-5 hours of treatment. Hypoglycemia may develop rapidly with correction of ketoacidosis due to improved insulin sensitivity.
- 11. Insulin Therapy hypoglycemia is a common mistake Rebound ketosis derived by counter- regulatory hormones. necessitates a longer duration of treatment other hazard ---- cerebral edema.
- 12. Electrolyte Correction (potassium) • do not administer potassium> 6 mEq/L • 10 mEq/h of potassium chloride.4.5-6 mEq/L • 20 mEq/h of potassium chloride.3-4.5 mEq/L
- 13. Electrolyte Correction (potassium) Monitor hourly infusion stopped K > 5 mEq/L. continue monitoring recurrence of hypokalemia.
- 14. Electrolyte Correction (potassium) In severe hypokalemia not starting insulin therapy unless potassium replacement cardiac dysrhythmia
- 15. Electrolyte Correction (potassium) Add 20-40 mEq/L of KCl when K level < 5.5 mEq/L. Potassium can be given as follows: two thirds as KCl, one third as KPO4.
- 16. Correction of Acid-Base Balance if decompensated acidosis sodium bicarbonate is indicated, 100-150 mL of 1.4% concentration is infused initially. repeated every half hour if necessary Rapid and early correction may worsen hypokalemia
- 17. Treatment of Concurrent Infection Proper antibiotics ---------- culture and sensitivity studies. Starting empiric antibiotics.