How do you manage pediatric ketoacidosis?

Continuous, low-dose, intravenous (IV) insulin infusion is generally accepted as the safest and most effective method of insulin delivery for treating diabetic ketoacidosis.

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Keeping this in view, how do you monitor DKA?

You can check for ketones using a urine test or blood test, which are available at most pharmacies.

A simple urine test that involves peeing on a Ketostix or dipping the Ketostix into a cup of urine, and observing the color change on the strip. …
A blood test can be done with special ketone test strips.

Then, how do you test for ketoacidosis? The ketone test is usually done using a urine sample or a blood sample. Ketone testing is usually done when DKA is suspected: Most often, urine testing is done first. If the urine is positive for ketones, most often a ketone called beta-hydroxybutyrate is measured in the blood.

One may also ask, is blood sugar high or low with ketoacidosis?

Diabetic ketoacidosis usually manifests with high blood glucose more than 250 mg/dL, but euglycemic diabetic ketoacidosis is defined as ketoacidosis associated with blood glucose level less than 250 mg/dL.

What are the 3 diagnostic criteria for DKA?

DIFFERENTIAL DIAGNOSIS

Three key features of diabetic acidosis are hyperglycemia, ketosis, and acidosis. The conditions that cause these metabolic abnormalities overlap.

What are the key nursing responsibilities when treating DKA?

Nursing Management

Monitor vitals.
Check blood sugars and treat with insulin as ordered.
Start two large-bore IVs.
Administer fluids as recommended.
Check electrolytes as potassium levels will drop with insulin treatment.
Check renal function.
Assess mental status.
Look for signs of infection (a common cause of DKA)

What is the anion gap for DKA?

In mild DKA, anion gap is greater than 10 and in moderate or severe DKA the anion gap is greater than 12. These figures differentiate DKA from HHS where blood glucose is greater than 600 mg/dL but pH is greater than 7.3 and serum bicarbonate greater than 15 mEq/L.

What is the first line treatment for DKA?

Treatment usually involves: Fluid replacement. You’ll receive fluids — either by mouth or through a vein — until you’re rehydrated. The fluids will replace those you’ve lost through excessive urination, as well as help dilute the excess sugar in your blood.

What is the protocol for DKA?

A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.

When do you give Lantus to DKA?

A dose of glargine (Lantus®) is given subcutaneously after resolution of the DKA (i.e. when the intravenous insulin is stopped). This is currently the standard-of-care practice for children in DKA.

When should DKA protocol be stopped?

DKA is resolved when 1) plasma glucose is <200–250 mg/dL; 2) serum bicarbonate concentration is ≥15 mEq/L; 3) venous blood pH is >7.3; and 4) anion gap is ≤12. In general, resolution of hyperglycemia, normalization of bicarbonate level, and closure of anion gap is sufficient to stop insulin infusion.