*NURSING > iHuman Case Studies > Walden UniversityNURS 6550i-human Management Plan Week 8 DKA (All)

Walden UniversityNURS 6550i-human Management Plan Week 8 DKA

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Primary Diagnosis: Diabetic Ketoacidosis (DKA) Status/Condition: (Critical, Guarded, Stable, etc.) Critical Code Status: Full Code Allergies: NKDA Admit to Unit: Yes (Westerberg, 2013) Activity ... Level: Bed rest Diet: NPO IVF (if ordered, include type and rate ): Start IV fluids now. Fluid loss averages approximately 6–9 L in DKA. The goal is to replace the total volume loss within 24–36 hours with 50% of resuscitation fluid being administered during the first 8–12 hours. A crystalloid fluid is the initial fluid of choice (Gosmanov, Gosmanova, & Dillard-Cannon, 2014) Critical Drips(If ordered, include type and rate. Do not defer to ICU Protocol): Insulin Drip, Endo-tool • Start intravenous fluids before insulin therapy. • Potassium level should be >3.3 mEq/L before the initiation of insulin therapy (supplement potassium intravenously if needed). • Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h. Measure bedside glucose every 1 hour to adjust the insulin infusion rate. • Avoid hypoglycemia during the insulin infusion by initiating dextrose-containing fluids and/or reduction of insulin infusion rate until DKA is resolved. • Transition to subcutaneous insulin only when DKA resolution is established. [Show More]

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