What is the nursing priority for DKA?
After initial stabilization of circulation, airway, and breathing as a priority, specific treatment of DKA requires correction of hyperglycemia with intravenous insulin, frequent monitoring, and replacement of electrolytes, mainly potassium, correction of hypovolemia with intravenous fluids, and correction of acidosis.
What is the priority in treating a patient with DKA?
The initial priority in the treatment of diabetic ketoacidosis is the restoration of extra-cellular fluid volume through the intravenous administration of a normal saline (0.9 percent sodium chloride) solution.
What is the nursing intervention for hyperemesis gravidarum?
Reestablishing normal fluid and electrolyte levels often relieves nausea and vomiting. Encourage the patient to eat, and tell her to avoid going for a long period without eating. Advise her to eat when she feels hungry, starting with small, frequent lowfat meals. She should avoid drinking fluids with meals.
Why ketoacidosis occurs in hyperemesis gravidarum?
With the loss of gastrointestinal contents and inadequate intake, it can lead to acid–base disturbance, especially in pregnant woman. After a lengthy fast, hepatic glycogen stores are quickly depleted, and lipid mobilization is enhanced, thus resulting in ketone body generation and acidosis.
What should you administer in DKA?
Treatment usually involves:
- Fluid replacement. You’ll receive fluids — either by mouth or through a vein — until you’re rehydrated.
- Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride.
- Insulin therapy.
How do you treat PT with DKA?
Administer 0.9% sodium chloride solution at first, then 0.45% sodium chloride solution as ordered. Expect to administer up to 1 or more liters of fluid per hour over the first few hours of treatment. Monitor the patient’s vital signs, serum sodium level, breath sounds, and urine output to assess for fluid overload.
When do you give Bicarb to DKA?
Consensus guidelines for the management of DKA recommended administering sodium bicarbonate to DKA patients who present with an initial blood gas pH of < 7.0. That recommendation was updated and changed in 2009 to limit sodium bicarbonate use to DKA patients with blood gas pH of < 6.9.
Who is at higher risk for hyperemesis gravidarum?
Age: Most studies agreed that hyperemesis gravidarum is more common among young aged mothers [12,13]. Moreover, young age of pregnant women also carries a risk of prolonged duration of the disease more than 27 gestational weeks [14,15].
What medication is prescribed for hyperemesis gravidarum?
Table 2
| Agent | Dosage | Efficacy |
|---|---|---|
| Diphenhydramine | 12.5–25 mg every 4–6 h | Reduces nausea and vomiting |
| Droperidol and diphenhydramine | 1.0–2.5 mg over 15 min, then 1.0 mg/h | Reduces nausea and vomiting |
| 50 mg over 30 min every 6 h | ||
| Ondansetron | 4 mg every 8 h | Reduces nausea and vomiting after first dose |
Does hyperemesis cause ketosis?
Hyperemesis gravidarum, unlike morning sickness, can cause weight loss, ketosis, dehydration, and sometimes electrolyte abnormalities. Exclude other disorders that can cause vomiting based on the woman’s symptoms.