DIABETIC

KETOACIDOSIS
 What is DIABETIC KETOACIDOSIS ?
 Diabetic ketoacidosis (DKA) is a serious
and potentially
What is DIABETIC KETOACIDOSISlife-threatening
?
complication
 Diabetic ketoacidosis of diabetes
(DKA) mellitus.
is a serious It
and potentially
typically
life-threatening occurs in individuals
complication of diabeteswith type It
mellitus.
1 diabetes,
typically occurs but can with
in individuals also affect
type 1those
diabetes, but
withthose
can also affect type 2with
diabetes
type 2under certain
diabetes under
circumstances.
certain circumstances.
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 Diabeticketoacidosis
Diabetic ketoacidosis (DKA) isand
(DKA) is a serious a serious
potentially
and potentially
life-threatening life-threatening
complication of diabetes mellitus. It
complication
typically occurs of diabetes
in individuals mellitus.
with type It
1 diabetes, but
typically
can also affect thoseoccurs in individuals
with type 2 diabeteswith type
under
1 diabetes, but can also affect those
certain circumstances
with type 2 diabetes under certain
circumstances

PAGE 01
Causative Effects
4. Poor management of diabetes:
Missed insulin doses or inadequate insulin
Inadequate monitoring of blood sugar levels,
administration: Failure to take insulin as
improper dietary choices, excessive alcohol
prescribed or not using enough insulin can lead
consumption, or non-compliance with
to a buildup of glucose in the bloodstream,
diabetes management plans can contribute
causing high blood sugar levels and a
to the development of DKA
subsequent energy shortage in cells.
2. Illness or infection: Infections, such as
urinary tract infections or respiratory infections,
can trigger a stress response in the body,
causing an increase in blood
kk sugar levels. kk
Additionally, illnesses or infections can make it
harder for the body to process insulin
effectively.
3. Physical or emotional stress: Physical stress,
such as trauma, surgery, or severe illness, can
cause the body to release stress hormones that
raise blood sugar levels. Emotional stress can
also have a similar effect.

PAGE 02
 other symptoms appear:
Signs and symptoms
• Constantly feeling tired
• Fry or flushed skin
DKA usually develops slowly. But when
• Nausea, vomiting, or abdominal pain.
vomiting occurs, this life-threatening
• Fruity odor on breath
condition can develop in a few hours. Early
• A hard time paying attention, or confusion
symptoms include the ff:
• Muscle stiffness or aches
• Thirst or a very dry mouth
• Frequent urination
• High blood glucose (blood sugar) level
• High level of ketones inkkthe urine kk

PAGE 03
Medical/ Surgical Manifestations Try to eat normally: It’s important to eat as
Follow your healthcare provider’s instructions: you normally do, especially if you are sick.
They will tell you how much insulin and/or If you take insulin, be sure to take the
medication to take and other steps to safely get appropriate amount with your meal as
out of or prevent DKA. directed by your healthcare provider.
Check your blood sugar often: Try to check your Don't exercise: Physical activity can
blood sugar every hour to be sure that your increase your blood sugar and increase
treatment is working and that your blood sugar is ketones in your body. Your healthcare
decreasing safely. provider will let you know when you can
Check your ketones: Use urine ketone strips or a start exercising again.
blood ketone meter to check
kk for ketones as kk
you're recovering to be sure that the level of
ketones in your body is decreasing and not
increasing.
Drink fluids to prevent dehydration: Drink water,
broth or sugar-free drinks to stay hydrated. This is
especially important if you are sick and/or
vomiting.

Page 04
Diagnosis and test What tests are used to diagnose diabetes-
How is DKA (diabetes-related ketoacidosis) related ketoacidosis (DKA)?
diagnosed? -In the hospital, healthcare providers may
Diabetes-related ketoacidosis is generally use the following tests to diagnose DKA:
diagnosed if you have the following four
conditions: • Blood glucose test.
•Ketone testing (through a urine or blood
•Blood glucose (sugar) level is above 250 test).
mg/dL. (It’s possible for you to be in DKA even •Arterial blood gas.
if your blood sugar is lower than 250. This is •Basic metabolic panel.
known as euglycemic diabetes-related •Blood pressure check.
kk
kk
ketoacidosis [euDKA], and it’s not as •Osmolality blood test
common.)
•Blood pH is less than 7.3 (acidosis).
• Presence of ketones in the urine and/or
blood.
•The serum (blood) bicarbonate level is less
than 18 mEq per L.

PAGE 05
Page 05
Preventions
• Manage your diabetes
• Monitor your blood sugar level
• Adjust your insulin dosage as needed
• Check your ketone level.
• Be prepared to act quickly
Diabetes complications are scary. But don't let
fear keep you from taking good care of
yourself. Follow your diabetes treatment plan
carefully. Ask your diabetes treatment team
kk
for help when you need it.
Nursing interventions
Monitor vitals
Check blood sugars and treat with insulin as ordered
Start two large-bore IVs
Administer fluids as recommended
Check electrolytes as potassium levels will drop with insulin
treatment
Check renal function
Assess mental status
Look for signs of infection (a common cause of DKA)
Educate the patient on the importance of compliance with
diabetic medications
Educate the patient on the importance of follow up
Check urine output kk
Encourage patient to quit smoking and abstain from alcohol
Encourage a healthy diet
Ask the patient to wear an ID bracelet signifying that he or
she has had a DKA episode
Check urine and blood cultures
Listen to the lungs for rales and crackles

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