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Diabetic Ketoacidosis

WHAT YOU NEED TO KNOW:

Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your blood sugar levels become high because your 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 your body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in your blood. Ketones are dangerous at high levels.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you 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 medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

You may need extra oxygen

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

Monitoring:

Your weight may be measured each day to monitor dehydration. Healthcare providers compare your weight from day to day to record how much body fluid you have. You may also need any of the following:

  • A heart monitor is an EKG that stays on continuously to record your heart's electrical activity.
  • A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine.
  • Intake and output may be measured. Healthcare providers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask healthcare providers if they need to measure or collect your urine.
  • Neuro signs , or neuro checks show healthcare providers your brain function. They will check how your pupils react to light. They may check your memory and how easily you wake up. Your 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.
  • Potassium may be given if your blood levels of potassium are low. This can happen when large amounts of insulin are given.

Tests:

  • Blood and urine tests will show your ketone and blood sugar levels. They will also show if you are dehydrated or have an infection.
  • An arterial blood gas (ABG) test measures the amount of oxygen and carbon dioxide in your blood.
  • A chest x-ray may show signs of infection.
  • An EKG test records your heart rhythm and how fast your heart beats.

Treatment:

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your 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 stomach. The NG tube is also used to give you medicines or liquids if you cannot swallow. The NG tube is put down your nose and into your 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 blood pressure or for taking blood.
  • A ventilator is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your mouth or nose and attached to the ventilator. You may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision and into your windpipe.

Diabetes education:

Healthcare providers will teach you how to manage your diabetes. A healthcare provider may also visit you at home to teach you more about diabetes, or you may attend classes. They will teach you what to do if your 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.

RISKS:

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

CARE AGREEMENT:

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

© 2016 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.

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