Diabetic Ketoacidosis In Children

WHAT YOU SHOULD KNOW:

Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your child's blood sugar levels become high because his body does not have enough insulin. Insulin helps move sugar out of the blood so it can be used for energy. The lack of insulin forces his body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in the blood. Ketones are dangerous at high levels.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

Your child may develop severe dehydration. This can cause abnormal heartbeats. Blood flow may be decreased and cause organ failure. Decreased blood flow to your child's brain may lead to seizures, swelling, or a coma. Treatment may cause your child's blood sugar level to become too low. Very low blood sugar levels may cause seizures, or he may become unconscious. Too much fluid replacement may cause trouble breathing or cerebral edema (water around the brain). DKA can be life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

An IV

is a small tube placed in your child's vein that is used to give him medicine or liquids.

Your child may need extra oxygen

if his blood oxygen level is lower than it should be. Your child may get oxygen through a mask placed over his nose and mouth or through small tubes placed in his nostrils. Ask your child's healthcare provider before you take off the mask or oxygen tubing.

Monitoring:

Your child's weight may be measured each day to monitor dehydration. Healthcare providers compare his weight from day to day to record how much body fluid he has. Your child may also need any of the following:

  • Intake and output may be measured. Healthcare providers will keep track of the amount of liquid your child is getting. They also may need to know how much he is urinating. Ask healthcare providers if they need to measure or collect your child's urine.

  • Neuro signs , or neuro checks show healthcare providers your child's brain function. They will check how his pupils react to light. They may check his memory and how easily he wakes up. Your child's hand grasp and balance may also be tested.

Medicines:

  • IV liquids help treat dehydration. Electrolytes may be added to the fluids to replace what has been lost from your body.

  • Insulin decreases the amount of sugar in your blood. You may need to take insulin until your blood sugar level becomes normal.

  • Glucose may be needed when your blood sugar level begins to decrease. This is to prevent your blood sugar level from dropping too quickly while you are getting insulin.

  • Antibiotics are given if a bacterial infection caused your child's DKA.

Tests:

  • Blood and urine tests will show your child's ketone and blood sugar levels. They will also show if he is dehydrated or has an infection.

  • An arterial blood gas (ABG) test measures the amount of oxygen and carbon dioxide in your child's blood.

  • A chest x-ray may show signs of infection.

  • An EKG test records your child's heart rhythm and how fast his heart beats.

Treatment:

  • A Foley catheter is a tube put into your child's bladder to drain urine into a bag. Keep the bag below your child's waist. This will prevent urine from flowing back into his bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out.

  • A nasogastric (NG) tube helps remove fluid from your child's stomach. The NG tube is also used to give him medicines or liquids if he cannot swallow. The NG tube is put down his nose and into his stomach.

  • An arterial line is a tube that is placed into an artery (blood vessel), usually in the wrist or groin. An arterial line may be used for measuring your child's blood pressure or for taking blood.

  • A ventilator is a machine that gives your child oxygen and breathes for him when he cannot breathe well on his own. An endotracheal (ET) tube is put into his mouth or nose and attached to the ventilator. Your child may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision and into his windpipe.

Diabetes education:

Healthcare providers will teach you how to manage your child's diabetes. A healthcare provider may also visit you and your child at home to teach you more about diabetes, or you may attend classes. They will teach you what to do if your child's blood sugar level goes too high or too low. They will also help you plan sick day management. Ask how to dispose of used needles and syringes.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Diabetic Ketoacidosis In Children (Inpatient Care)

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