Diabetic ketoacidosis is a State associated with diabetes

1. DIABETIC KITOACIDOSIS MANAGEMENT
PRESENTER –
ANKIT KUMAR ARYA
BSC “N” 2ND YEAR
BHAARATH COLLEGE OF
NURSING, CH-73

3. SUBTOPICS:-
• Introduction
• Defintion
• Causes
• Pathophysiology
• Clinical manifestation
• Assessment and diagnostic findings
• Management
• Prevention
• Summary
• Conclusion
• Journal Abstract
• Bibliography

4. INTRODUCTION
•It is a serious complication of diabetes, characterized by
high levels of ketones in blood, resulting in metabolic
acidosis. It is a medical emergency that requires prompt
treatment.

5. DEFINITION:-
•Diabetic ketoacidosis (DKA) is a serious and
potentially life-theatening complication of
diabetes mellitus. It occurs when there is
severe lack of insulin in the body, resulting in
high blood sugar level (hyperglycemia), The
breakdown of fat for energy and the
production of ketones in the blood.

6. CAUSE:-
•Continuous fasting
•Improper insulin therapy/Treatment of
insulin
•Physical trauma
•Cardiac Arrest
•Pancreatitis
•Pregnancy
•Alcohol consumption

7. PATHOPHYSIOLOGY

8. • Ketones are formed when body has inadequate
glucose.
• It occurs during dieting, fasting and as overnight
process. During this period insulin levels become low
and glucagon and epinephrine levels are in normal.
This situation promotes fat cells to release fat for
burning up/ for energy. This converts it into ketone
bodies and circulate in the blood stream. Majority of
the ketones are oxidized, few particles rest in body
and are excreated into urine and exhaled as acetone
breath Exhaled.

9. CLINICAL MANIFESTATION:-
• Acetone Breath
• Halitosis
• Kussmaul respirations
>The hyperglycemia of DKA leads to
• Polyuria
• Polydipsia
• Marked fatigue
>The ketosis and acidosis of DKA leads to gastrointestinal
symptoms,
• anorexia
• nausea
• Vomiting

10. ASSESSMENT AND DIAGNOSTIC FINDINGS
History Collection :-Prolonged Fasting, Dieting, kussmaul
Respiration, Acetone Breath
Physical Examination :- Respiration, Acetone Breath
Diagnostic investigation :- CBC, Acetone Breath test,
Urinary Analysis test (presence of ketone Body in urine) ,
Sample should be collected from 24 hr Urine collection bag
to get accurate measurement.
Check for increased level of creatinine, blood urea
nitrogen(BUN) And Hematocrit

11. MANAGEMENT:-
Diabetic ketoacidosis (DKA) is a medical emergency that
requires prompt and coordinate medical, surgical and
Nursing management. Here’s an overview of each:
MEDICAL MANAGEMENT:-
1. Diagnosis and Stablization:-
Prompt diagnosis is essential and treatment should
begin immediately. The patient’s airway, breathing and
circulation should be assessed and appropriate
interventions should be initiated.
2. Fluid replacement :- Iv fluid containing saline and

12. CONT...
• 3. Insulin therapy:- Continuous IV insulin infusion is the
mainstay of therapy to lower blood glucose levels and stop
ketone production.
• 4. Correction of electrolyte imbalances:- Electrolyte
imbalances, particularly potassium, should be corrected.
• 5. Treatment of underlying causes:- The underlying cause of
DKA, such as infection, missed insulin does doses or other
factors, must be addressed.
• SURGICAL MANAGEMENT:-
• Surgical management is usually not required in Diabetic

13. NURSING MANAGEMENT:-
1.Monitoring:-Frequent monitoring of blood glucose
levels, electrolytes, vital signs and urine output is
essential.
2. Administering medications and IV Fluids:- Nurses
administer medications as prescribed and adjust IV
Fluid maintain hydration and electrolyte balance.
3. Assessing and managing Complications:- Nurses should
be vigilant for Complications, such as
hypoglycemia,hypokalemia and fluid overload and take

14. CONT.....
• 4. Patient Education:-
Patient and their families should receive education
about DKA and how to prevent it. This includes
monitoring blood glucose levels, taking insulin as
priscribed and recognizing sings of DKA.
Overall the management of DKA requires the
multidisciplinary approach, involving medical, Surgical
and nursing management. Early recognition and prompt
treatment. Early recognition and prompt treatment are

15. PREVENTION:-
The best way to prevent diabetic Ketoacidosis (DKA) to
manage your diabetes effectively.
Some steps can taken to prevent DKA.
1. insulin or diabetes medicine should be taken as
príscribed
2. Blood sugar Level Should be monitored regularly.
3. healthy diet should be followed.
4. Hydration Should be maintained.
• 5. medical attention Should be given promply.
By following these steps and working closely with your

16. SUMMARY:-
Diabetic ketoacidosis (DKA) is a serious complication
of diabetes. That occurs when the body. Produces
high level of ketones due to a lack of insulin. It is
most common in type 1 diabetes. But also occurs in
type-2 diabetes. Symptoms including high blood
sugar levels, excessive thirst and fruity-smelling
breath.
Treatment involves replacing fluids, correcting blood
sugar level with Insulin and adressing underlying
causes.
Preventing DKA involves careful diabetes

17. CONCLUSION:-
Diabetic ketoacidosis (DKA) is a severe and life-
threatning complication of diabetes that can result in
high ketone levels, leading to a range of symptoms. It is
commonly seen in people with type-1 diabetes. But can
also occurs in people with type 2 diabetes.
Treatment involves prompt replacement of fluids and
electrolytes, correction of blood sugar levels with insulin
therapy and adressing underlying causes. Prevention is
key and careful management of diabetes is essential to
avoide DKA. Working closely with healthcare providers
can help prevent complications and improve overall

18. JOURNAL ABSTRACT:-
Title: “Predictors of intensive care unit admission and in-hospital mortality in
patients with diabetic kitoacidosis; A retrospective study”
Journal: Diabetes Research and clinical Practice.
Authors: Kim SH, Park JY, Lee KA, et al.
Publication Date: October 2021
Abstract: Diabetic ketoacidosis (DKA) is a potentially life-threating
complication of Diabetes mellitus. This retrospective study aimed to identify
predictors of intensive care unit ICU admission and in-hospital mortality in
patients with DKA who where admitted to a tertiary hospital between january
2015 and December 2019. Multivariable logistic regression.
Analyses were performed to identify predictors to ICU admission and
in-hospital mortality of the 290 patients, 58(20.0%) were admitted
to ICU and 12 (4.1%) died during hospitalization. The following factors

19. CONT...
Were admission indipendently associated with ICU admission:
older
age (≥65 years), low initial serum bicarbonate level (<10
mmol/L), high
initial serum lactate level (5 mmol/L) and mechanical
Ventilation. Our findings suggest that these factors can be
used to identify patient with DKA who are at high risk of ICU
admission and in-hospital mortality. Timely identification
and management of these patients may improve outcomes..

20. BIBLIOGRAPHY:-
• 1. Kitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA.
Hyperglycemic crises in adult patients with diabetes. Diabetes
Care. 2004;27
• 2. American Diabetes Association. Standards of Medical Care in
Diabetes-2021. Diabetes Care. 2021;44
• 3. Joint British Diabetes Societies Inpatient Care Group. The
Management of Diabetic Ketoacidosis in Adults. 3rd ed. 2013.

21. EVALUATION/QUESTION SESSION:-
• Which of the following is a common symptom of diabetic
ketoacidosis?
• A). Hypoglycemia
• B). Polyuria
• C). Bradycardia
• D). Hypertension

22. Ans:-B

23. •Diabetic kitoacidosis leads.............?
a)High ketone
b)High glucose
c)High potassium

24. Ans- A

25. • Treatment of diabetic kitoacidosis?
• A) Replacement of fluid
• B) Correcting blood sugar level with insulin
• C) Both

26. Ans:-C

27. ASSIGNMENT
• Write an assignment on Assessment and Findings of
Diabetic Kitoacidosis.