DKA dx?

ChristineN, BSN, RN · Jul 28, 2014

I don't have a link but the diagnosis criteria should be the same regardless of where in the hospital the pt is. Generally with DKA you must have metabolic acidosis along with hyperglycemia and ketones in the urine. How high the glucose levels are really does not matter as much as the pH and bicarb levels.

MunoRN, RN · Jul 28, 2014

The criteria that's been used where I've worked is primarily based on anion gap; Serum sodium - (chloride+bicarb or CO2) as well as ketone levels. We track pH, osmolality, and of course BG levels but they aren't the primary drivers of the diagnosis. A patient can have a severely elevated BG and not be in DKA, and a patient can have a normal BG level and be in DKA. A positive anion gap would be 12 or greater. The DKA is considered "resolved" when the anion gap returns to normal and ketones are cleared to normal levels.

turnforthenurse, MSN, NP · Aug 1, 2014

Where I work we look at the blood sugar, ketones in urine, beta-hydroxybutyric acid and pH via venous blood gas. Diabetic ketoacidosis involves a metabolic acidosis hence increased ketones and acidotic pH. Blood glucose does not necessarily mean that a patient is in DKA. We recently had a patient with a 350 blood sugar that was in DKA. Another patient >900 that wasn't.