Nursing Care Plan for Diabetic Ketoacidosis
Diabetic Ketoacidosis (DKA) is a potentially life threatening condition of diabetes occurring mostly in patients with Type 1 diabetes but on occasion also in patients with Type 2 diabetes. This disease is a potentially fatal complication of diabetes that occurs when insulin levels are far lower than what the body needs.
The most frequent early signs of Diabetic Ketoacidosis or DKA is a sharp increase in polydipsia and polyuria. Whilst Polydipsia means excessive thirst, Polyuria refers to the excessive production of dilute urine. Other symptoms include malaise, generalized weakness, and tiredness. These may then progress if untreated to vomiting, deep gasping breathing (kussmaul respiration), dehydration, rapid weight loss in patients newly diagnosed with Type 1 diabetes, mild disorientation, confusion and occasionally coma.
Imbalanced Nutrition : Less than Body Requirements related to the insufficiency of insulin, decreased oral input, hyper-metabolic status.
Expected outcomes: The client will;
- Digesting the number of calories / nutrients right.
- Shows the energy level normally.
- Demonstrating steady weight or adding appropriate normal range.
Interventions :
1. Monitor weight daily or as indicated.
R:/ Assessing adequate food intake, including absorption and utilities.
2. Determine the diet and eating patterns of patients and compare it with the food being spent.
R:/ Identify deficiencies and deviations from the therapeutic needs
3. Auscultation bowel sounds, note the presence of abdominal pain / abdominal bloating, nausea, vomit undigested food, keep fasting as indicated.
R:/ Hyperglycemia and disorders of fluid and electrolyte balance may decrease motility / function of the stomach (distention or paralytic ileus) that will affect the choice of intervention.
4. Give foods that contain nutrients then try giving a more solid that can be tolerated.
R:/ Oral feeding is better if the patient is conscious and good gastrointestinal function.
5. Involve patients in planning family as indicated.
R:/ Provide information on the family to understand the nutritional needs of the patient.
6. Observation of signs of hypoglycemia.
R:/ Hypoglycemia can occur because of a reduced carbohydrate metabolism while still given insulin, it can potentially be life threatening and should be recognized.
Collaboration:
1. Monitor proofing acetone, pH and HCO3.
R:/ Monitor the effectiveness of insulin in order to stay in control.
2. Give regular insulin treatment as indicated.
R:/ Facilitate the transition on carbohydrate metabolism and lowers the incidence of hypoglycemia.
3. Examination of blood sugar.
R:/ Monitor blood sugar is more accurate than the reduction of urine to detect fluctuations.
