How is fluid status monitored in the acute stage of DKA?!

Question: I have some answers down... but I think my instructor is looking for more. Any ideas?

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Answers: I have some answers down... but I think my instructor is looking for more. Any ideas?

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When we have DKA patients come in, you have to assume they are already about 5 liters dehydrated so you start running fluids. You can calculate fluid deficits based on their sodium level, but you need to adjust their sodium that you get on the lab for the amount of glucose that is in their blood. You continue to run fluids until their sugars come back down and they can get off of the insulin drip. It's all a complete balance game but there is no exact number.


Here is an algorithim I use for when patients come in with DKA:

http://www.aafp.org/afp/20050501/1705.ht...

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In addition to what Jill O said, monitor serum potassium. As the sugar drops, K++ will also be dropping, sometimes at an alarming rate, watch for cardiac problems. IV's might be ordered with 20-40 mEq of K++.

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