DKA - urine output

[friendlylark]

I am a new nurse, with just over 1 year of experience. I am learning more and more about DKA and wondering the pathophysiology behind DKA.

What is the reason we should be monitoring the patient's urine output while treating DKA. Yesterday, the doctor order 4,000 liters of NS and a foley catheter. Are foley's always indicated in DKA?

From the DKA protocol, the fluids should be changed to D5 1/2 NS with K for a patient who has K less than 5.5. My patient had K of 4.5. I gave her 3 liters, and she had only given 50 cc of urine.

What am I watching for with urine output in DKA?

[Esme12, ASN, BSN, RN]

These patients are extremely dehydrated......large amounts of fluids are given to rehydrate them and hopefully ward off acute failure. YOu need to watch for fluid over load/CHF/Pulmonary Edema AND when the U/o increases to watch the electrolytes.

DKA medscape....medscape is an excellent reference. You have to register but it is free.

Diabetic Ketoacidosis - American Family Physician

[CDEWannaBe]

Esme covered it.

DKA is caused by both high blood sugars and the dehydrations the high blood sugars cause. When blood sugar levels are extremely high the glucose is not getting to the cells and instead the kidneys are removing the excess glucose form the blood and flush it out using any available water in the body. The irony is that it causes severe dehyration and can concentrates glucose in the blood.

Any high blood sugar will cause thirst and excessive urination as the kidneys flush out excess glucose. I've been in DKA a couple times over my 35 years of having diabetes. For mild DKA an IV helped me recover within hours. But when I experienced severe DKA and was in a DKA induced coma, it took weeks for me to feel fully rehydrated and recovered. Thankfully it's been a long time since that happened. Hope it won't ever again.