THE LESSONS TO BE LEARNT ABOUT DKA / CLINICAL JUDGEMENT

Updated 5/25

Scenario: Tom was admitted to the ICU, with the clinical
picture of a patient in diabetic ketoacidosis (DKA). His blood
glucose was 600. Tom has an altered level of consciousness (LOC).
He also has hyperglycemia (elevated blood glucose).
Please watch the video below:
Dehydration

Signs and symptoms of DKA

The patient in DKA requires immediate intervention and a level
 of care like ICU.

Some signs that may appear include:

- Hyperglycemia

- Tachycardia (rapid heart rate)

- Tachypnea (rapid breathing)

- Polyuria (excessive urination)

- Polydipsia (excessive thirst)

- Flushed face

- Breath has a fruity odor

Please enjoy the video:
Patient education

Medical management is necessary for the patient in DKA.
Frequent monitoring of blood glucose, Insulin IV, Potassium
replacements are included in the management.

The clinical scenario above demonstrates the
situation of a new nurse. She is assigned to the ER
 and is really scared. She does not know how to get
organized.
** A word of caution. Nursing is a wonderful profession.
Taking care of the sick and helping them to get well, is a
 great accomplishment. Perfecting good clinical judgement 
and performance, cannot be accomplished by high scores only.