The management is clearly presented and divided into a number of key steps in the care. It can also occur in patients with other types of diabetes. You are free to use the slides in presentations without further permission as long as the slide content is not altered in any way and appropriate attribution is made to the american diabetes association the association name and logo on the slides constitutes appropriate attribution. It seems like you waste quite a lot of thi diabetic ketoacidosis nursing management ppt and then the product itself isnt worth it. The contents of this presentation is part of my notes in medicalsurgical nursing. Dka is a far more characteristic feature of type 1 than of type 2 diabetes but may be seen in persons with type 2 diabetes under conditions of stress. Diabetic ketoacidosis dka and hyperglycemic hyperosmolar state hhs are acute metabolic complications of diabetes mellitus that can occur in patients with both type 1 and 2 diabetes mellitus. Wednesday diabetes selfmanagement education dsme for preventable hypoglycemia. Diabetic ketoacidosis and hyperosmolar nonketotic coma diabetic ketoacidosis and hyperosmolar nonketotic coma diabetic ketoacidosis a condition precipitated by stress or other illness or omission of insulin insulin. The management is clearly presented and divided into a number of. Dka adalah komplikasi akut dari diabetes melitus yang mengancam nyawa. Diabetic ketoacidosis presentation of new onset diabetes about 30 of the time is a lifethreatening emergency the metabolic abnormalities must be corrected in a careful, vigilant fashion 3 diabetic ketoacidosis.
Treatment diabetic ketoacidosis is an emergency and requires urgent medical attention, often in and intensive care setting. All they had to do was offer to send a new one instead of blaming diabetic ketoacidosis nursing management diabetes mellitus treatment guidelines pdf ppt me and the problems would have been solved. Diabetic ketoacidosis hyperglycemia diabetes mellitus. Ispad 2009, mcgeoch 2007, savage 2006, bsped 2004, kitabchi 2009. Hospitalizations for diabetic ketoacidosis as firstlisted diagnosis in adults with diabetes, united states. Guidelines for management of diabetic ketoacidosis. Powerpoint slide on diabetic ketoacidosis dka compiled by alairic reuben. Diabetic ketoacidosis singapore pdf ppt case reports. Diabetic ketoacidosis dka is a lifethreatening emergency caused by a relative or absolute deficiency of insulin.
If not diagnosed and treated with insulin, the person with type 1 diabetes will eventually develop a lifethreatening condition known as diabetic ketoacidosis keytoeasidoesis or dka. Presentations ppt, key, pdf logging in or signing up. Pathophysiology and treatment diabetic ketoacidosis dka, also known as diabetic acidosis or diabetic coma, is a severe complication of diabetes mellitus dm. Diabetic ketoacidosis dka powerpoint slides myprivatetutor. It happens predominantly in those with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances. They include increased thirst and urination, hunger, weight loss, dry skin, and sometimes blurred vision. Diabetic ketoacidosis clinical presentation history insidious increased thirst ie, polydipsia and urination ie, polyuria are the most common early symptoms of diabetic ketoacidosis dka. We examined the frequency and severity of diabetic ketoacidosis dka in 679 children and adolescents 014 years at diagnosis of type 1 diabetes mellitus t1dm in. Diabetic ketoacidosis and hyperosmolar hyperglycemic. Evolving strategies for diabetes education resources in the 21st century. Diabetic ketoacidosis management update slideshare. Diabetes insulin transition iv to subcutaneous adult supplemental 5254. Timely diagnosis, comprehensive clinical and biochemical evaluation, and effective management is key to the successful resolution of dka and hhs.
Diabetic ketoacidosis a sweet new approach to an old problem outline dka background the new. Argy resident february, 2007 diabetic ketoacidosis dka a state of absolute or relative insulin deficiency aggravated. More commonly seen in patients with type 1 diabetes t1d, dka results when lipid breakdown generates a surplus of acidic. Remove this presentation flag as inappropriate i dont like this i like this remember as a favorite. The biochemical criteria for the diagnosis of diabetic ketoacidosis dka are.
Reem sallam, md, msc, phd clinical chemistry unit, pathology dept. Overlap the insulin drip with the sq insulin by 2 or more hours. Kad didefinisikan sebagai suatu trias yang terdiri dari hiperglikemi, ketonemia, dan asidosis. Nauseavomiting thirstpolyuria abdominal pain shortness of breath physical findings. The new model standardised diagnosis check for high risk criteria standard fluid orders. Introduction diabetic ketoacidosis dka is a potentially life threatening complication in people with diabetes mellitus. The management is clearly presented and divided into a number of key steps in the care pathway. Ketoacidosis at first presentation of type 1 diabetes. At presentation, the specific deficits in an individual patient vary depending upon the duration and severity of illness, the extent.
Since there is considerable progress in the field of medicinenursing, there maybe interventions, drugs of choice, and other related factors that are still incorporated. The 2009 american diabetes association ada position statement on hyperglycaemic emergencies in adult patients with diabetes details the management of diabetic ketoacidosis dka and hyperosmolar hyperglycaemia state. The adobe flash plugin is needed to view this content. In the last decade, however, there has been a change in the way patients with dka present clinically and in addition there has been rapid development of nearpatient testing. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. The fundamental pathophysiology of this potentially lifethreatening complication is the same as in adults. Hyperglycemia is a key diagnostic criterion of dka. Diabetes state burden toolkit ddt burden toolkit home. Ppt diabetic ketoacidosis powerpoint presentation free to view id. At presentation k level is normal or high k is shifted to ecc in. The adage a child is not a miniature adult is most appropriate when considering diabetic ketoacidosis dka. The goal of treatment is to correct the elevated blood glucose level by giving additional insulin and to replace fluids and electrolytes lost through excessive urination and vomiting.
However, the child differs from the adult in a number of characteristics. Current state of dsmt reimbursement and healthcare reform. In addition to timely identification of the precipitating cause, the first step in acute management of these disorders includes aggressive administration of intravenous fluids with appropriate replacement of electrolytes primarily. Differential diagnosis of ketosis and anion gap acidosis features diabetic alcohol starvation uraemic ketoacidosis ketoacidosis ketoacidosis acidosis lactic acidosis ph plasma glucose anion gap serum ketones serum osmolality 14th edition of joslins diabetes mellitus 9. Diabetic ketoacidosis dka is considered to be a common presentation of both type 1 diabetes mellitus and type 2 diabetes mellitus in children and adolescents.
Diabetic ketoacidosis dka, a hallmark of type 1 diabetes, is the result of uncontrolled production of ketone bodies 3hydroxybuturate and acetoacetic acid, leading to a lowering of blood ph. After being a diabetic for many years, im happy to report that thanks to your. Diabetic ketoacidosisdiabetic keto acidosis is an acute state of severeuncontrolled. In contrast, the mean age for diabetic ketoacidosis dka is early in the fourth decade of life. Diabetic foot ulcerations are one of the most common complications associated w diabetes with a global annual incidence of 6.
The management of diabetic ketoacidosis in adults pdf 2m b order reference. Diabetic ketoacidosis dka is a common, serious, and preventable complication of type 1 diabetes, with a mortality of 35%. The management is clearly presented and divided into a. Pdf euglycemic diabetic ketoacidosis, a misleading. Nursing assessment assess skin for dehydration like poor turgour,flushing, and dry mucus membrances.
Case study a 43yearold gentleman with a long history of type 2 diabetes 6 years, dyslipidemia and hypertension presented to the emergency department with a 6day history of weakness, fever, nausea, vomiting and a painful left foot with foul smelling pus discharge from ulcer. More than 50% of diabetic ulcers become infected and 20% of. This deficiency in available insulin results in disorders in the metabolism of carbohydrate, fat, and protein. History insidious increased thirst ie, polydipsia and urination ie, polyuria are the most common early symptoms of diabetic ketoacidosis dka. Diabetic ketoacidosis australia pdf ppt case reports. Main clinical features of dka are hyperglycemia, acidosis, dehydration, and electrolyte losses such as hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and.
The management of diabetic ketoacidosis in adults ketan dhatariya. Diabetic ketoacidosis is a serious complication of type 1 diabetes, though its sometimes seen in people with type 2 diabetes. Sills, md albany medical center albany, ny 2 diabetic ketoacidosis presentation of new onset diabetes about 30 of the time is a lifethreatening emergency the metabolic abnormalities must be corrected in a careful, vigilant fashion 3 diabetic ketoacidosis. Diabetic ketoacidosis and hyperglycaemic hyperosmolar state gmed. Ppt diabetic ketoacidosis dka powerpoint presentation, free. Ppt diabetes ketoacidosis powerpoint presentation free. Diabetic ketoacidosis dka though preventable remains a frequent and life threatening complication of. The lifetime incidence of foot ulcers in diabetic patients is 19 34%. A free powerpoint ppt presentation displayed as a flash slide show on id. As rates of obesity increase amongst children, the prevalence of type 2 diabetes mellitus is also rising in this age group and may lead to an increased incidence of hhs in this population. Ketogenesis in the liver is triggered by low levels of insulin and high levels of glucagon. Diabetic ketoacidosis free download as powerpoint presentation. Diabetic ketoacidosis university of pittsburgh powerpoint presentation presentation title. Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome hhs are life threatening complications that occur in patients with diabetes.
In fact, one third of patients admitted for hyperglycemia exhibit characteristics of both hhs and dka. Diabetic ketoacidosis dka is an acute, major, lifethreatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. Introduction hhs and dka are not mutually exclusive but rather two conditions that both result from some degree of insulin deficiency. Diabetic ketoacidosis 1 diabetic ketoacidosis irene n. A comprehensive diabetic foot exam should be conducted by a podiatrist, physician or other health care provider who is knowledgeable about diabetes and its. Diabetic nephropathy occurs in 2040% of patients with diabetes and is the single leading cause of endstage renal disease esrd persistent albuminuria in the. When blood sugar levels are too high and insulin levels are too low. Euglycemic diabetic ketoacidosis, a misleading presentation of diabetic ketoacidosis article pdf available in north american journal of medical sciences 76. Guidelines and position statements from medical organisations are widely used by clinicians to guide the care of their patients. Presentation slides american association of diabetes. Diabetic ketoacidosis ppt presentation free download.
Diabetic ketoacidosis dka, though preventable, remains a frequent and life threatening. This section focuses on the medical management of type 2 diabetes. Practice guidelines resources american diabetes association. Pediatric diabetic ketoacidosis clinical presentation.
Severe insulin deficiency occurs in previously undiagnosed type 1 diabetes mellitus. The 2020 standards of medical care in diabetes includes all of adas current clinical practice recommendations and is intended to provide clinicians, patients, researchers, payers, and others with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. Diabetic ketoacidosis dka management algorithm adult. Diabetic ketoacidosis, together with the major complication of cerebral edema, is the most important cause of mortality and severe morbidity in pediatric cases of diabetes, particularly at the time of first diagnosis. Ppt diabetic ketoacidosis powerpoint presentation free to download id.
It is characterized by a triad of increased total body ketone concentration, metabolic acidosis, and uncontrolled hyperglycemia. American diabetes association presentation summary. Diabetic ketoacidosis dka may be a complication existing type 1 diabetes mellitus or be the first. Ppt diabetic ketoacidosis powerpoint presentation free. Diabetic ketoacidosis dka is one of the most serious complications of diabetes.