a nurse is caring for a child who is receiving treatment for diabetic ketoacidosis This is a topic that many people are looking for. bluevelvetrestaurant.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, bluevelvetrestaurant.com would like to introduce to you Diabetic Ketoacidosis: DKA Pathophysiology and Nursing Interventions (Step-By-Step). Following along are instructions in the video below:
There friend in this video lecture. We are talking about the pathophysiology and nursing interventions interventions for diabetic keotacidosis. Im going to break down the pathophysiology into super simple for you to follow these steps are super helpful for students so stick around because you will finally understand it after this video and write love in the comments below.
If you want more full video lectures just like this one to help you out with nursing school. I want to know what you think now lets do it so dka in a nutshell happens. When there is not enough insulin in the body insulin is required to help move glucose into the cells glucose is the cells best energy source.
So without insulin the cells cant get any glucose. So because the cells. Dont have insulin the cells start converting fat into energy instead and this fat breakdown leads to ketones building up in the blood.
Which are acids. So thats just a brief overview of whats going on here now dka happens mostly in patients with type 1 diabetes. But it can also happen with type 2.
Although thats pretty rare so lets think about this dka happens. When there is not enough insulin in the body and during type 1 diabetes. The pancreas isnt making any insulin.
So thats why it mostly happens in type 1 diabetes. During type 2 diabetes. The cells become resistant to insulin so in type 2 diabetes.
Its really not a problem of a lack of insulin in the body. But rather a lack of insulins ability to move glucose into the cell. Because the cells are resistant to that insulin.
This is pretty rare though dka mostly happens in type 1 diabetes. But in either case insulin cant get glucose into the cell. So lets walk through what happens step by step now you wont see these steps anywhere else theyre not official or anything i just made them up to make learning all of this easier.
So you wont find them in your textbook or anything step. 1 of the pathophysiology of diabetic ketoacidosis. Is there is not enough insulin.
So normally in your body your pancreas produces.
Insulin and insulins job is to grab onto glucose and move it into the cells. So that the cells can use them for energy. But in the case of diabetic ketoacidosis.
There isnt enough insulin and this leads to hyperglycemia. Which is of the pathophysiology of dka this causes hyperglycemia because there isnt any insulin around to move glucose into the cells. So all of that glucose just builds up and builds up in the blood.
It cant get into the cell. Its stuck outside so the cells are there really wanting their glucose because they need energy. But thankfully they have some stored up fat to use for energy.
And this is of dka. The cells use fat as energy and heres a key point you need to know about diabetic ketoacidosis. When fat is converted into energy ketones are produced and ketones are acids.
This is step. 4. Ketones are produced as a biproduct of fat metabolism.
This is a key point to remember for dka. The cells use fat for energy instead of glucose and when fat is broken down ketones are released and ketones are acids and because theres all that acid release it leads to step number 5. Which is acidosis the more the ketone levels rise in the body the more the acid level rises in the body because ketones are acids and so the more ketones.
There are the more serious the acidosis becomes and this is considered metabolic acidosis. If you want a deep dive on metabolic acidosis. Dont worry weve got you covered.
Ive got a whole video on metabolic acidosis that you can check out ill put the link in the description below in that video. I walk you through what it is and what causes it so you will definitely want to check it out so now that we know the pathophysiology of diabetic keotacidosis. Lets talk about the nursing interventions for dka.
So what are the things youll do as a nurse to help fix it there are several nursing interventions you might do for a patient with dka these might be things like giving fluids. Giving insulin and continuing to assess them if youre in the nursingsos membership community. You know that im always talking about how important the nursing assessment is and actually that reminds me i have a free nursing assessment cheat sheet for you.
But its even better than a cheat sheet.
Its a full assessment transcript. So it literally walks you through the nursing assessment. Word.
For word. So you can use it as a guide. When you practice assessing a patient.
Its amazing youre going to love it ill put a link to it in the description below this video for you to check it out. So lets talk about fluid treatment for dka. Giving fluids is one of the 2 main treatments.
Youll do for a patient. With dka. The goal here is to reduce the blood glucose level and keep the patients organs perfused of course fluid treatment will depend on what the doctor has ordered but typically youll give normal saline lactated ringers half normal saline or five to ten percent dextrose in half normal saline.
There are different reasons for giving these different fluids. So lets walk through them normal saline or lactated ringers is usually given first because these solutions are isotonic meaning. They are not going to force fluid any which way those solutions are going to stay inside the blood vessels.
Which is where we want them half normal saline may be used after normal saline or lactated ringers in order to hydrate the cells because half normal saline solution will push some fluid inside the cells to help rehydrate them you may also give five to ten percent dextrose in half normal saline as the blood glucose level drops to around 250 to 300 miligrams per decileter. Now this can be confusing. Why would we give glucose when were trying to drop the patients blood glucose level well this is super.
Important because we dont want it to drop. Too much we are basically controlling the blood glucose level by giving some more glucose and controlling the rate that the blood glucose level decreases lets think about it if we just give normal fluids without glucose plus insulin that insulin could drop the blood glucose level way to fast. So when the blood glucose level reaches between 250 to 300 miligrams per decileter.
You might give glucose along with fluids depending on the doctors orders so that is the rationale for each of those iv fluids. If you want a deeper dive into iv fluids. We have a whole video on that for you to check out its super good and will give you a quick and easy breakdown of isotonic hypertonic and hypotonic solutions.
Ill put the link to that video in the description. Too now lets talk about insulin treatment. So we know that the core problem and the pathophysiology of dka is a lack of insulin.
So obviously well need to give insulin to help the cells take up that glucose for energy.
So they can stop using fat for energy and stop producing those acidic ketones depending on the doctors orders you might give regular insulin through the iv to help move that glucose into the body cells. If you do this you will need to constantly assess their blood glucose level during treatment because you dont want to drop their blood sugar. Too fast and heres why.
The body is always wanting to be in balance. So if you drop the blood glucose level. Too fast the water in the body will try to re balance itself and move from the intracellular fluid called the.
Icf to the extracellular fluid called the ecf and if this happens too fast fluid will move into the cerebrospinal fluid to try to maintain that balance and this can lead to swelling in the brain. And can cause increased intracranial pressure. This is super dangerous and causes even more of a medical emergency.
So its really important that you always assess your patient and be very careful when giving insulin and fluid treatment and of course. Like i said. Im a stickler for the nursing assessment.
So lets walk through some things youll need to assess youll assess their intake and output their weight and continually monitor their respirations youll assess their iv assess their fluids and fluid status make sure the correct fluids are infusing like they should be check their blood glucose levels their abg values and their potassium and sodium levels. Diabetic ketoacidosis can seriously mess up the fluid and electrolyte balance in the body. So its important to keep an eye on it you will also constantly assess their mental status to clue you in on any increased.
Intracranial pressure like we said before if the fluid shifts into the cerebrospinal fluid. It can cause swelling on the brain. And increased intracranial pressure.
So you need to always be assessing for that friend you are a rock star nursing student. I know all of this is a lot to learn. But just because youre here with me right now watching this video tells me that youre doing better than you think you are you are obviously super dedicated to becoming the best nurse.
You can be so keep going and dont give up i know you can do it. If this video helped you out write love in the comments below to let me. Know you want more full video lectures just like this one to help you out with nursing school.
I want to know what you think and of course make sure to subscribe and click. The bell for more videos to help you raise your grades and have more free time in nursing school and in the next video. Well walk through the dka lab values you need to know about now go become.
The nurse that god created only you to be ill see you in the next video. .
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