Nursing 4400A/B Chapter Notes - Chapter 6: Cardiac Arrhythmia, Perfusion, Capillary Refill
16 Dec 2016
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Identifyinf the causation and development of diabetic ketoacidosis (dka) helps in understanding the signs, symptoms, care and complications of cerebral oedema. Its management requires skilled nursing and involves fluid therapy, iv insulin, coreection of potassium imbalance and strict vigilance for potentially lethal complications. Dka is a co(cid:373)(cid:373)o(cid:374) e(cid:373)erge(cid:374)cy i(cid:374) childre(cid:374)"s (cid:374)ursi(cid:374)g a(cid:374)d is (cid:373)ost ofte(cid:374) associated with (cid:374)ewly diagnosed type 1 diabetes (often a presenting factor). 28% of children aged under 5 years with newly diagnosed type 1 diabetes presented with dka. Leading cause of morbidity and death in children with type 1 diabetes. Cerebral oedema accounts for more than half of dka-related deaths. Causes of dka have a common initiating factor: insulin deficiency. This results in hyperglycaemia which leads to glycosuria and osmotic diuresis. At this point the child can compensate by drinking more fluid. Insulin deficiency is also associated with excess production of counter-regulatory hormones (glucagon, adrenaline, cortisol, and growth hormone) which act in opposition to insulin.
