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DKA Pathophys

Diabetic ketoacidosis (DKA) is a serious complication primarily affecting patients with diabetes mellitus, especially Type 1, due to insufficient insulin levels leading to fat breakdown and ketone production, resulting in metabolic acidosis. The condition can be precipitated by factors such as infections, inadequate insulin therapy, and acute stress, causing symptoms like nausea, vomiting, and confusion. Treatment focuses on stabilizing the patient through rehydration, insulin therapy, and monitoring vital signs and electrolytes, while educating patients on insulin care and DKA prevention.

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11 views2 pages

DKA Pathophys

Diabetic ketoacidosis (DKA) is a serious complication primarily affecting patients with diabetes mellitus, especially Type 1, due to insufficient insulin levels leading to fat breakdown and ketone production, resulting in metabolic acidosis. The condition can be precipitated by factors such as infections, inadequate insulin therapy, and acute stress, causing symptoms like nausea, vomiting, and confusion. Treatment focuses on stabilizing the patient through rehydration, insulin therapy, and monitoring vital signs and electrolytes, while educating patients on insulin care and DKA prevention.

Uploaded by

jennylaz100
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Predisposing Factors Precipitating Factors

 Type 1 Diabetes Mellitus (DM)  Infection (e.g., urinary tract infection,


 Type 2 Diabetes Mellitus pneumonia).
 Insulin deficiency  Non-compliance or inadequate insulin therapy
(e.g., missed doses)
 Acute stress (e.g., surgery, trauma).
 Illness or new-onset diabetes.
 Psychological stress or emotional
 trauma

Glucose builds up in
thirst frequent urination
the bloodstream

dehydration Weight loss


n
absence of sufficient glucose

The body starts breaking ketonuria


down fat for energy

Accumulation of Blood
through production of
ketones

Metabolic Acidosis  Nausea


decrease in the pH  Vomiting
 abdominal pain

The body attempts to


 Fatigue
compensate for acidosis
 Confusion
through Kussmaul
 Lethargy
respirations to expel excess
 Blurred vision
CO2

Diabetic Ketoacidosis

Legends

Risk Factors

Disease Process

Signs and Symptoms

Disease
Diabetic ketoacidosis (DKA) mainly occurs in patients with diabetes mellitus; it is more common in
Type 1 diabetes, though DKA may occur in Type 2 diabetes under certain circumstances. It is a
potentially fatal complication caused by the body's inability to utilize glucose as a source of energy
due to insufficient insulin levels. This causes the body to start breaking down fat stores for energy,
producing ketones, which accumulate in the bloodstream and cause metabolic acidosis.

DKA development starts when insulin levels drop, either because of inadequate insulin therapy,
insulin resistance, or a stressor (such as infection, illness, or trauma). Without sufficient insulin,
glucose cannot enter the cells to be used for energy. The liver now begins to metabolize fats into
fatty acids and ketones as a source of fuel. Though this presents an alternative energy source, the
level of ketones in the blood increases.

With the buildup of ketones, the blood tends to be acidic, leading to metabolic acidosis. Apart from
ketone production, the inability of insulin to promote glucose entry into cells brings about
hyperglycemia, leading to osmotic diuresis. There is excretion of large quantities of water and
electrolytes through the kidneys with dehydration and disturbance of electrolytes. All this in
conjunction with respiratory compensation that comes in terms of Kussmaul breathing for acidosis
results in such a complex presentation of DKA.

The goal for medical management is stabilization of the patient through treatment of metabolic
disturbances and normalization of glucose levels. It involves rehydration with IV fluids, such as
isotonic saline, to reverse dehydration and maximize renal perfusion. Insulin therapy is generally a
continuous IV infusion, can lower blood glucose and halt production of ketones without causing
dangerous swings, and the potassium level must be maintained because insulin causes a shift of
potassium into cells and can be replaced to avoid potentially severe complications. Acidosis can be
corrected using only insulin alone. However, it is crucial that bicarbonate only be reserved for severe
acidosis. Important for treatment: recognize and correct the underlying cause. A basic nursing
approach for this is a regular close watch on patient vital signs, glucose levels in blood, electrolytes,
and output of urine. Nurses teach patients about the care of insulin, stress management, and some
early signs of DKA so that patients may prevent or timely intervention in occurrence to avoid
cerebral edema or hypoglycemia conditions.

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