Diabetic Ketoacidosis Case Study
Brittney Jacobs
Rasmussen College
NUR2063
Professor: Shaun Creary-Walker
August 16, 2020
, DKA 2
Diabetic Ketoacidosis Case Study
Diabetic ketoacidosis (DKA) is a life-threatening emergency caused by a relative or
absolute deficiency of insulin characterized by hyperglycemia, acidosis, and ketonuria. Although
DKA occurs mainly in type 1 diabetes mellitus (T1DM), it can occur in people with T2DM
(Doenges, Moorhouse & Murr, 2019). DKA is the most serious complication that occurs in
diabetics and is most often precipitated by illness, especially infection (Winkelman &
Ignatavicius, 2015). This paper will examine the pathophysiology and etiology of DKA, clinical
manifestations, treatment plan, and nursing care for the patient presenting with ketoacidosis.
Diabetic ketoacidosis is one of the life-threatening acute complications of diabetes
mellitus. It is often seen among patients who are poorly compliant to insulin administration
during an acute illness or precipitated by a stressful event such as infection (Pathophysiology,
n.d.). The presence of these stressful conditions stimulates the release of counter-regulatory
hormones glucagon, catecholamines and growth hormone which induce the mobilization of
energy stores of fat, glycogen, and protein (Pathophysiology, n.d.). The result is the production
of glucose. As circulating glucose levels in the bloodstream rise, a healthy pancreas releases
insulin, which helps the glucose enter the cells for fuel (Perkins, 2017). When insulin is released
into the bloodstream, it meets the cell membrane and combines with a receptor that allows
glucose transporters to be activated (Perkins, 2017). As a result of absent insulin release in
patients with diabetes mellitus, DKA is characterized by sustained hyperglycemia in the blood
(Pathophysiology, n.d.). Deprived of glucose, the body’s cells begin to metabolize fats and
proteins, depositing unusually high levels of wastes called ketones in the blood and causing a
condition called ketosis. The production of ketones outweighs its excretion by the kidneys
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