Question

1. What is the pathophysiology of DKA and what type of diabetes will this patient have? 2. What impact can age related changes have on the patient experiencing DKA? 3. What signs and symptoms would the nurse expect to see in the DKA? What are the 3 cardinal

number 2

Answer 1

1. For type 1 diabetes patients, blood sugar is very high and acidic substance called ketones build up to dangerous level and that condition is called diabetic ketoacidosis . Insulin deficiency causes the body to metabolize triglycerides and amino acids instead of glucose for energy. Serum levels of glycerol and fatty acids rise because of unrestrained lipolysis. Glycerol and alanine provide substrate for hepatic gluconeogenesis. Glucagon also stimulates mitochondrial conversion of free fatty acids into ketones. Insulin normally block ketogenesis. But the ketogenesis proceeds in the absence of insulin. The major ketoacids produced, acetoacetic acid and beta-hydroxybutric acids are strong organic acids that create metabolic acidosis. Acetone derived from the metabolism of acetoacetic acid accumulates in serum and slowly disposed of by respiration. 2. The younger the child,it is more difficult to obtain the history of polyuria,polydipsiaand weight loss. Because the diagnosis of diabetes is not suspected ,the duration of symptoms may longer which results to fatal complications such as severe dehydration and later into coma. Even in the case of adults, untreated diabetic ketoacidosis can cause potentially  fatal complications such as severe dehydration which leads to acute kidney failure,respiratory distress syndrome,coma and swelling of the brain. 3.The nurse could expect for the signs and symptoms in the DKA patients are confusion,frequent urination,nausea &vomiting,dehydration,deep,rapid breathing,dry mouth and skin, fruity smelling breath,shortness of breath, excessive thirst,abdominal pain.