Materiały źródłowe

• #1 Diabetic coma – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475

  A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] If you go into a diabetic coma, you’re alive but you can’t wake up or respond purposefully to sights, sounds or other types of stimulation. If it’s not treated, a diabetic coma can result in death. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] If you’re with someone with diabetes who has passed out, call for emergency help. Tell the emergency personnel that the unconscious person has diabetes. […] Good day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind: Follow your meal plan. Consistent snacks and meals can help you control your blood sugar level.

• #2 What happens if you go into a diabetic coma?

  https://www.lcmchealth.org/blog/2024/november/what-happens-if-you-go-into-a-diabetic-coma-/

  A diabetic coma is a period of unconsciousness without responsiveness to any stimulation. A medical emergency that can be fatal if left untreated, a diabetic coma can be reversed by treating the underlying condition, and blood sugar stabilizes. […] Anyone with diabetes can experience a diabetic coma, but you can take steps to lower your risk by effectively managing your condition. One critical step you can take is to be sure you’re able to recognize the signs of your blood sugar getting out of control. […] Both extremely high or extremely low blood sugar can cause blurry vision, confusion, and headache. If you experience any of these symptoms, check in with a medical provider. […] Its possible to develop some of the causes of diabetic coma before you even know you have diabetes.

• #3 Diabetic coma | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/diabetic-coma

  A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] If you go into a diabetic coma, you’re alive but you can’t wake up or respond purposefully to sights, sounds or other types of stimulation. If it’s not treated, a diabetic coma can result in death. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] If you’re with someone with diabetes who has passed out, call for emergency help. Tell the emergency personnel that the unconscious person has diabetes. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low.

• #4 Diabetic coma | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma

  The 3 types of diabetic coma include diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. […] Diabetic coma is a medical emergency and needs prompt medical treatment. […] Uncontrolled diabetes may lead to a diabetic coma or unconsciousness. […] First aid for someone who has lapsed into a diabetic coma includes: Call triple zero (000) for an ambulance immediately. […] A coma is a medical emergency. A quick diagnosis can save the persons life. […] Treatment options for diabetic coma include: ketoacidotic coma intravenous fluids, insulin and administration of potassium. […] hyperosmolar coma intravenous fluids, insulin, potassium and sodium given as soon as possible. […] hypoglycaemic coma an injection of glucagon (if available) to reverse the effects of insulin or administration of intravenous glucose.

• #5 Diabetic Ketoacidosis (DKA): Your Guide to Diabetic Coma

  https://www.trifectanutrition.com/health/diabetic-ketoacidosis-dka-guide-to-diabetic-coma?srsltid=AfmBOopYIpotkb0fVrfbCVNHuSP-D-aFxrdp3LiVqMxgaqz7CNWCuF1a

  Diabetic coma is the term used to describe a mental state change in people with diabetes from extreme fluctuations in blood sugar levels. […] Someone with these mental state changes may be confused, have seizures, or be in a state of unresponsive coma. […] A diabetic coma can result from three main causes: Hypoglycemia, Diabetic Ketoacidosis (DKA), Hyperosmolar Hyperglycemic State (HHS). […] DKA treatment requires improving the acidosis, hyperglycemia, and dehydration by carefully giving the right amount of insulin and fluid and fixing dangerous electrolyte abnormalities (in particular correcting potassium levels). […] Because proper management of DKA is so intensive, it often requires hospital admission to the intensive care unit (ICU) for extremely close monitoring and treatment. […] The best ways to prevent diabetic ketoacidosis includes: Frequent blood glucose checks, Well controlled diet, Regulated exercise, Consistent medication. […] Diabetics with positive ketones should always be evaluated by a doctor to ensure they are not in diabetic ketoacidosis.

• #6 What happens if you go into a diabetic coma?

  https://www.lcmchealth.org/blog/2024/november/what-happens-if-you-go-into-a-diabetic-coma-/

  A diabetic coma is a period of unconsciousness without responsiveness to any stimulation. A medical emergency that can be fatal if left untreated, a diabetic coma can be reversed by treating the underlying condition, and blood sugar stabilizes. […] Anyone with diabetes can experience a diabetic coma, but you can take steps to lower your risk by effectively managing your condition. One critical step you can take is to be sure you’re able to recognize the signs of your blood sugar getting out of control. […] Both extremely high or extremely low blood sugar can cause blurry vision, confusion, and headache. If you experience any of these symptoms, check in with a medical provider. […] Its possible to develop some of the causes of diabetic coma before you even know you have diabetes.

• #7

  https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4952917

  Ketoacidosis is one of the most extreme complications of diabetes mellitus. Unfortunately, most cases of ketoacidosis are in patients that were not previously known to be diabetic, so the owner (and pet) must deal with two serious diagnoses: one acutely life-threatening and expensive and the other requiring ongoing commitment and daily treatment. […] The diabetic patient has an insulin deficiency. To recap, there is a huge amount of glucose in the bloodstream, but without insulin, none of it can get inside the cells that need it. It just circulates around uselessly. The tissues, some of which require glucose as their only food, are starving. Add to this some sort of second stressful condition, such as infection or pancreatitis, and the tissue demand for food/fuel increases. The tissues, including the brain, become especially desperate, and the body begins to break down fat frantically in order to liberate the small amount of carbohydrates (which can convert to glucose) contained therein.

• #8 Nursing Care Plan for Diabetic Ketoacidosis (DKA) | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-diabetic-ketoacidosis-dka-2

  Diabetic ketoacidosis is a serious complication of diabetes mellitus that occurs when uncontrolled blood sugar rises and the body cant produce enough insulin to use the glucose. […] DKA is often the result of an underlying infection such as a common cold, flu or bacterial infection like pneumonia or urinary tract infections. […] Monitor blood glucose levels and administer insulin as appropriate. […] Monitor fluid and electrolyte balance to prevent dehydration and complications such as decreased sodium, potassium, calcium and magnesium. […] Monitor for and treat signs / symptoms of infection. […] Administer medications as appropriate. […] Monitor vitals for signs / symptoms of hypovolemia. […] Prevent injury and falls; assist with ambulation. […] Nutrition and lifestyle education. […] Maintaining a high blood glucose level, missing doses of insulin or being sick can cause ketones to form in the blood.

• #9 Nurses’ Experiences in Caring Diabetic Ketoacidosis Patients in the Emergency Departments: A Qualitative Study

  https://clinmedjournals.org/articles/ijccem/international-journal-of-critical-care-and-emergency-medicine-ijccem-10-166.php?jid=ijccem

  Background: Diabetic ketoacidosis (DKA) is a critical complication of diabetes mellitus requiring prompt and effective management to prevent adverse outcomes. […] This qualitative case study aims to explore nurses’ experiences and challenges, on DKA management within the emergency department (ED) of a Regional Referral Hospital (RRHs) in Dar es Salaam Tanzania. […] Methodology: A descriptive qualitative study was conducted to understand nurses’ experiences in managing patients with diabetic ketoacidosis in the emergency department. […] The interview guide written in Kiswahili was used to collect data. […] Results: Two main themes emerged from the study including variability in nursing interventions for DKA management and clinical challenges in DKA management. […] Variability in nursing interventions included three categories variability in correction of dehydrations, correction of hyperglycemia and correction of electrolyte.

• #10 Diabetes-Related Coma: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16628-diabetic-coma

  A diabetes-related coma is a life-threatening emergency that can happen from having very high or very low blood sugar. […] A person in a diabetes-related coma needs immediate medical attention. Call 911 or your local emergency number. […] If you dont get treatment for HHS in time, it can lead to a coma. […] If you dont get treatment for DKA in time, it can lead to a coma. […] Prolonged severe hypoglycemia thats not treated in time can lead to a coma. […] If someone near you goes into a diabetes-related coma, follow these first-aid steps: Immediately call 911 or your local emergency services number for an ambulance. […] A diabetes-related coma is a medical emergency. Anyone in a coma needs treatment in a hospital. […] The treatment for a diabetes-related coma depends on the cause. But all cases need treatment in a hospital.

• #11 Diabetes-Related Coma: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16628-diabetic-coma

  A diabetes-related coma is a life-threatening emergency that can happen from having very high or very low blood sugar. […] A person in a diabetes-related coma needs immediate medical attention. Call 911 or your local emergency number. […] If you dont get treatment for HHS in time, it can lead to a coma. […] If you dont get treatment for DKA in time, it can lead to a coma. […] Prolonged severe hypoglycemia thats not treated in time can lead to a coma. […] If someone near you goes into a diabetes-related coma, follow these first-aid steps: Immediately call 911 or your local emergency services number for an ambulance. […] A diabetes-related coma is a medical emergency. Anyone in a coma needs treatment in a hospital. […] The treatment for a diabetes-related coma depends on the cause. But all cases need treatment in a hospital.

• #12 Med-Surg: Diabetes Complications – Hypoglycemia, DKA, HHS – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-19-diabetes-complications-hypoglycemia-dka-hhs?srsltid=AfmBOoovAnbezQc0YXyC4I9h6iJ6dXz8YSIIfS-3tOUu2jwYBR6Sauyw

  Hypoglycemia is a common complication seen in patients with diabetes wherein blood glucose levels drop below 70 mg/dL. […] The signs and symptoms of hypoglycemia include hunger, irritability, confusion, diaphoresis, headache, shakiness, blurred vision, pale, cool skin, and decreased level of consciousness that can progress into a coma. […] When you have a patient in a hypoglycemic state, your objective is to bring their blood glucose levels back up. The method by which you will do this depends upon if the patient is conscious or unconscious. […] For a patient that is conscious, you will need to quickly provide 15g of a readily-absorbed carbohydrate, like in juice or milk. […] If a patient is unconscious, they arent going to be swallowing any juice, so you will need to inject glucagon through the intramuscular or subcutaneous route.

• #13 Diabetic coma – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475

  Have a sick-day plan. Illness can cause an unexpected change in blood sugar. If you are sick and unable to eat, your blood sugar may drop. […] Check for ketones when your blood sugar is high. Check your urine for ketones when your blood sugar level is over 250 Milligrams per deciliter (mg/dL) (14 Millimoles per litre (mmol/L)) on more than two consecutive tests, especially if you are sick. […] Have glucagon and fast-acting sources of sugar available. If you take insulin for your diabetes, have an up-to-date glucagon kit and fast-acting sources of sugar, such as glucose tablets or orange juice, readily available to treat low blood sugar levels. […] Educate your loved ones, friends and co-workers. Teach loved ones and other close contacts how to recognize the early symptoms of blood sugar extremes and how to give emergency injections. If you pass out, someone should be able to call for emergency help. […] Wear a medical identification bracelet or necklace. If you’re unconscious, the bracelet or necklace can provide valuable information to your friends, co-workers and emergency personnel.

• #14 Med-Surg: Diabetes Complications – Hypoglycemia, DKA, HHS – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-19-diabetes-complications-hypoglycemia-dka-hhs?srsltid=AfmBOoovAnbezQc0YXyC4I9h6iJ6dXz8YSIIfS-3tOUu2jwYBR6Sauyw

  Hypoglycemia is a common complication seen in patients with diabetes wherein blood glucose levels drop below 70 mg/dL. […] The signs and symptoms of hypoglycemia include hunger, irritability, confusion, diaphoresis, headache, shakiness, blurred vision, pale, cool skin, and decreased level of consciousness that can progress into a coma. […] When you have a patient in a hypoglycemic state, your objective is to bring their blood glucose levels back up. The method by which you will do this depends upon if the patient is conscious or unconscious. […] For a patient that is conscious, you will need to quickly provide 15g of a readily-absorbed carbohydrate, like in juice or milk. […] If a patient is unconscious, they arent going to be swallowing any juice, so you will need to inject glucagon through the intramuscular or subcutaneous route.

• #15 How to care for DKA: An Expert Nurse’s Guide to Diabetic Ketoacidosis | Health And Willness

  https://healthandwillness.org/dka-diabetic-ketoacidosis/

  Patients who are in DKA are often obviously sick. […] They often are vomiting, may have abdominal pain, and appear dehydrated and weak. In severe cases, they can also have some altered mental status, especially if they haven’t been able to drink fluids. […] Patients in DKA are prone to severe electrolyte abnormalities such as hypokalemia, which can cause deadly cardiac arrhythmias to occur. […] Any sick patient that may require ICU should have at least 2 IVs placed, preferably at least 20g. These patients will need a large volume of fluid replacement as well as will likely require an insulin drip and IV potassium. […] Hang 1-2L of NS open to gravity (and of course obtain an order to verify). […] Ask for and administer medications such as Zofran or pain meds if the patient is nauseous or in severe pain.

• #16 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/

  Nursing interventions are directed at prevention. […] Fluid resuscitation is crucial in the management of patients with DKA. […] Monitor closely for alterations in cognition, posturing, and lethargy as signs of cerebral hypoperfusion. […] Administer isotonic solutions initially. […] To prevent a recurrence of DKA or when to seek prompt treatment, educate the patient on symptoms such as polydipsia, polyuria, nausea and vomiting, flushed skin, weakness, and fatigue.

• #17 Diabetes-Related Coma: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16628-diabetic-coma

  A diabetes-related coma is a life-threatening emergency that can happen from having very high or very low blood sugar. […] A person in a diabetes-related coma needs immediate medical attention. Call 911 or your local emergency number. […] If you dont get treatment for HHS in time, it can lead to a coma. […] If you dont get treatment for DKA in time, it can lead to a coma. […] Prolonged severe hypoglycemia thats not treated in time can lead to a coma. […] If someone near you goes into a diabetes-related coma, follow these first-aid steps: Immediately call 911 or your local emergency services number for an ambulance. […] A diabetes-related coma is a medical emergency. Anyone in a coma needs treatment in a hospital. […] The treatment for a diabetes-related coma depends on the cause. But all cases need treatment in a hospital.

• #18 Med-Surg: Diabetes Complications – Hypoglycemia, DKA, HHS – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-19-diabetes-complications-hypoglycemia-dka-hhs?srsltid=AfmBOoovAnbezQc0YXyC4I9h6iJ6dXz8YSIIfS-3tOUu2jwYBR6Sauyw

  Hypoglycemia is a common complication seen in patients with diabetes wherein blood glucose levels drop below 70 mg/dL. […] The signs and symptoms of hypoglycemia include hunger, irritability, confusion, diaphoresis, headache, shakiness, blurred vision, pale, cool skin, and decreased level of consciousness that can progress into a coma. […] When you have a patient in a hypoglycemic state, your objective is to bring their blood glucose levels back up. The method by which you will do this depends upon if the patient is conscious or unconscious. […] For a patient that is conscious, you will need to quickly provide 15g of a readily-absorbed carbohydrate, like in juice or milk. […] If a patient is unconscious, they arent going to be swallowing any juice, so you will need to inject glucagon through the intramuscular or subcutaneous route.

• #19 Diabetes-Related Coma: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16628-diabetic-coma

  A diabetes-related coma is a life-threatening emergency that can happen from having very high or very low blood sugar. […] A person in a diabetes-related coma needs immediate medical attention. Call 911 or your local emergency number. […] If you dont get treatment for HHS in time, it can lead to a coma. […] If you dont get treatment for DKA in time, it can lead to a coma. […] Prolonged severe hypoglycemia thats not treated in time can lead to a coma. […] If someone near you goes into a diabetes-related coma, follow these first-aid steps: Immediately call 911 or your local emergency services number for an ambulance. […] A diabetes-related coma is a medical emergency. Anyone in a coma needs treatment in a hospital. […] The treatment for a diabetes-related coma depends on the cause. But all cases need treatment in a hospital.

• #20 Diabetic coma – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479

  If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low. […] A diabetic coma is a medical emergency that you won’t have time to prepare for. […] If you’re with someone with diabetes who has passed out or is acting strange, possibly as if they have had too much alcohol, call for immediate medical help. […] If you have no training in diabetes care, wait for the emergency care team to arrive. […] If you are familiar with diabetes care, test the unconscious person’s blood sugar and follow these steps: […] If the blood sugar level is lower than 70 Milligrams per deciliter (mg/dL) (3.9 Millimoles per litre (mmol/L)), give the person an injection of glucagon. Do not try to give fluids to drink. Do not give insulin to someone with low blood sugar. […] If the blood sugar level is above 70 mg/dL (3.9 mmol/L) wait for medical help to arrive. Don’t give sugar to someone whose blood sugar isn’t low. […] If you called for medical help, tell the emergency care team about the diabetes and what steps you’ve taken, if any.

• #21 Nurses’ Experiences in Caring Diabetic Ketoacidosis Patients in the Emergency Departments: A Qualitative Study

  https://clinmedjournals.org/articles/ijccem/international-journal-of-critical-care-and-emergency-medicine-ijccem-10-166.php?jid=ijccem

  Conclusion: These findings underscore the urgent need for standardized training, design strategies to improved adherence to DKA management protocols, and the integration of point-of-care testing (POCT) to enhance timely and effective DKA management. […] While many nurses successfully managed DKA by adhering to established guidelines, some faced challenges due to gaps in their comprehensive knowledge of DKA management. […] Therefore, this theme describes nurses’ experiences when managing DKA where theme three sub-themes were identified: Correction of Dehydration, Correction of hyperglycemia and Correction of Electrolyte imbalance. […] The majority of nurses who participated in this study discussed mixed of responses regarding the amount of fluid to be used, type of fluid and time interval of fluid administration when managing patient with DKA at Emergency department. […] Surprisingly, some participants responded that the measured level of RBG determined the amount of fluid that DKA patient to be administered contrary to the available management protocol.

• #22 Ketoacidosis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568717/

  Nursing management roles in a patient with ketoacidosis include monitoring vitals, checking blood sugars and treating with insulin as ordered, starting two large-bore IVs, administering fluids as recommended, checking electrolytes as potassium levels will drop with insulin treatment, checking renal function, assessing mental status, looking for signs of infection, educating the patient on the importance of compliance with diabetic medications, educating the patient on the importance of follow up, checking urine output, encouraging the patient to quit smoking and abstain from alcohol, encouraging a healthy diet, asking the patient to wear an ID bracelet signifying that he or she has had a DKA episode, checking urine and blood cultures, and listening to the lungs for rales and crackles. […] The diabetic nurse should follow all outpatients to ensure medication compliance, follow up with clinicians, and adopt a positive lifestyle. […] The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care.

• #23 Diabetic coma – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479

  If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low. […] A diabetic coma is a medical emergency that you won’t have time to prepare for. […] If you’re with someone with diabetes who has passed out or is acting strange, possibly as if they have had too much alcohol, call for immediate medical help. […] If you have no training in diabetes care, wait for the emergency care team to arrive. […] If you are familiar with diabetes care, test the unconscious person’s blood sugar and follow these steps: […] If the blood sugar level is lower than 70 Milligrams per deciliter (mg/dL) (3.9 Millimoles per litre (mmol/L)), give the person an injection of glucagon. Do not try to give fluids to drink. Do not give insulin to someone with low blood sugar. […] If the blood sugar level is above 70 mg/dL (3.9 mmol/L) wait for medical help to arrive. Don’t give sugar to someone whose blood sugar isn’t low. […] If you called for medical help, tell the emergency care team about the diabetes and what steps you’ve taken, if any.

• #24 Studying the Role of Nurses in the Diabetic Ketoacidosis Management – Journal of Integrative Nursing and Palliative Care

  https://journalinpc.com/article/studying-the-role-of-nurses-in-the-diabetic-ketoacidosis-management-wpgdjuodfmcqalc

  Nurses have a role in the diagnosis, assessment, and management of diabetic ketoacidosis. […] Effective roles include maintaining fluid and electrolyte balance, setting the patient’s insulin dose, and sketching a discharge plan to exclude DKA recurrence. […] Management of ketoacidosis is an interdisciplinary team effort in which nurses play a key role in controlling, identifying, and prohibiting the progression and symptoms recurrence. […] For the effective management of ketoacidosis, the use of skilled and knowledgeable nurses is essential.

• #25 Ketoacidosis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568717/

  Nursing management roles in a patient with ketoacidosis include monitoring vitals, checking blood sugars and treating with insulin as ordered, starting two large-bore IVs, administering fluids as recommended, checking electrolytes as potassium levels will drop with insulin treatment, checking renal function, assessing mental status, looking for signs of infection, educating the patient on the importance of compliance with diabetic medications, educating the patient on the importance of follow up, checking urine output, encouraging the patient to quit smoking and abstain from alcohol, encouraging a healthy diet, asking the patient to wear an ID bracelet signifying that he or she has had a DKA episode, checking urine and blood cultures, and listening to the lungs for rales and crackles. […] The diabetic nurse should follow all outpatients to ensure medication compliance, follow up with clinicians, and adopt a positive lifestyle. […] The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care.

• #26 Diabetic coma – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479

  If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low. […] A diabetic coma is a medical emergency that you won’t have time to prepare for. […] If you’re with someone with diabetes who has passed out or is acting strange, possibly as if they have had too much alcohol, call for immediate medical help. […] If you have no training in diabetes care, wait for the emergency care team to arrive. […] If you are familiar with diabetes care, test the unconscious person’s blood sugar and follow these steps: […] If the blood sugar level is lower than 70 Milligrams per deciliter (mg/dL) (3.9 Millimoles per litre (mmol/L)), give the person an injection of glucagon. Do not try to give fluids to drink. Do not give insulin to someone with low blood sugar. […] If the blood sugar level is above 70 mg/dL (3.9 mmol/L) wait for medical help to arrive. Don’t give sugar to someone whose blood sugar isn’t low. […] If you called for medical help, tell the emergency care team about the diabetes and what steps you’ve taken, if any.

• #27 How to care for DKA: An Expert Nurse’s Guide to Diabetic Ketoacidosis | Health And Willness

  https://healthandwillness.org/dka-diabetic-ketoacidosis/

  Patients who are in DKA are often obviously sick. […] They often are vomiting, may have abdominal pain, and appear dehydrated and weak. In severe cases, they can also have some altered mental status, especially if they haven’t been able to drink fluids. […] Patients in DKA are prone to severe electrolyte abnormalities such as hypokalemia, which can cause deadly cardiac arrhythmias to occur. […] Any sick patient that may require ICU should have at least 2 IVs placed, preferably at least 20g. These patients will need a large volume of fluid replacement as well as will likely require an insulin drip and IV potassium. […] Hang 1-2L of NS open to gravity (and of course obtain an order to verify). […] Ask for and administer medications such as Zofran or pain meds if the patient is nauseous or in severe pain.

• #28 Diabetic coma – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479

  If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low. […] A diabetic coma is a medical emergency that you won’t have time to prepare for. […] If you’re with someone with diabetes who has passed out or is acting strange, possibly as if they have had too much alcohol, call for immediate medical help. […] If you have no training in diabetes care, wait for the emergency care team to arrive. […] If you are familiar with diabetes care, test the unconscious person’s blood sugar and follow these steps: […] If the blood sugar level is lower than 70 Milligrams per deciliter (mg/dL) (3.9 Millimoles per litre (mmol/L)), give the person an injection of glucagon. Do not try to give fluids to drink. Do not give insulin to someone with low blood sugar. […] If the blood sugar level is above 70 mg/dL (3.9 mmol/L) wait for medical help to arrive. Don’t give sugar to someone whose blood sugar isn’t low. […] If you called for medical help, tell the emergency care team about the diabetes and what steps you’ve taken, if any.

• #29 Ketoacidosis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568717/

  Nursing management roles in a patient with ketoacidosis include monitoring vitals, checking blood sugars and treating with insulin as ordered, starting two large-bore IVs, administering fluids as recommended, checking electrolytes as potassium levels will drop with insulin treatment, checking renal function, assessing mental status, looking for signs of infection, educating the patient on the importance of compliance with diabetic medications, educating the patient on the importance of follow up, checking urine output, encouraging the patient to quit smoking and abstain from alcohol, encouraging a healthy diet, asking the patient to wear an ID bracelet signifying that he or she has had a DKA episode, checking urine and blood cultures, and listening to the lungs for rales and crackles. […] The diabetic nurse should follow all outpatients to ensure medication compliance, follow up with clinicians, and adopt a positive lifestyle. […] The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care.

• #30 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/

  DKA requires prompt treatment and close monitoring as deterioration can lead to coma and death. […] Nurses must also educate patients and family members on how to recognize symptoms of DKA as well as prevent recurrences. […] Nursing interventions and care are essential for the patients recovery. […] The cornerstones of management in diabetic ketoacidosis are fluid resuscitation and maintenance, insulin therapy, electrolyte restoration, and supportive care. […] Immediate fluid resuscitation is essential to reverse hypovolemia, restore tissue perfusion, and eliminate ketones. […] IV short-acting insulin by continuous infusion is recommended until the glucose level is below 200 mg/dL. […] If the patient presents with hypokalemia, this must be addressed before administering insulin to prevent life-threatening cardiac arrhythmias.

• #31 Nurses’ Experiences in Caring Diabetic Ketoacidosis Patients in the Emergency Departments: A Qualitative Study

  https://clinmedjournals.org/articles/ijccem/international-journal-of-critical-care-and-emergency-medicine-ijccem-10-166.php?jid=ijccem

  Conclusion: These findings underscore the urgent need for standardized training, design strategies to improved adherence to DKA management protocols, and the integration of point-of-care testing (POCT) to enhance timely and effective DKA management. […] While many nurses successfully managed DKA by adhering to established guidelines, some faced challenges due to gaps in their comprehensive knowledge of DKA management. […] Therefore, this theme describes nurses’ experiences when managing DKA where theme three sub-themes were identified: Correction of Dehydration, Correction of hyperglycemia and Correction of Electrolyte imbalance. […] The majority of nurses who participated in this study discussed mixed of responses regarding the amount of fluid to be used, type of fluid and time interval of fluid administration when managing patient with DKA at Emergency department. […] Surprisingly, some participants responded that the measured level of RBG determined the amount of fluid that DKA patient to be administered contrary to the available management protocol.

• #32 4 Diabetic Ketoacidosis and HHNS Nursing Care Plans

  https://nurseslabs.com/diabetic-ketoacidosis-nursing-care-plans/

  The following are the nursing priorities for patients with Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome: Diagnose and recognize the signs and symptoms of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Administer intravenous fluids and electrolytes to correct dehydration and restore fluid balance. Monitor blood glucose levels regularly and administer insulin as prescribed. Assess and manage acid-base imbalances and electrolyte disturbances. Monitor vital signs, including blood pressure and heart rate. Administer supplemental oxygen if necessary. Educate patients and their caregivers about the importance of regular diabetes management, including medication adherence and monitoring blood glucose levels. Provide guidance on preventing future episodes of DKA or HHNS through proper diabetes self-care and lifestyle modifications. Schedule follow-up appointments to monitor recovery, assess glycemic control, and adjust treatment plans as needed.

• #33 Diabetic coma | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma

  The 3 types of diabetic coma include diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. […] Diabetic coma is a medical emergency and needs prompt medical treatment. […] Uncontrolled diabetes may lead to a diabetic coma or unconsciousness. […] First aid for someone who has lapsed into a diabetic coma includes: Call triple zero (000) for an ambulance immediately. […] A coma is a medical emergency. A quick diagnosis can save the persons life. […] Treatment options for diabetic coma include: ketoacidotic coma intravenous fluids, insulin and administration of potassium. […] hyperosmolar coma intravenous fluids, insulin, potassium and sodium given as soon as possible. […] hypoglycaemic coma an injection of glucagon (if available) to reverse the effects of insulin or administration of intravenous glucose.

• #34 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diabetic-Coma-Treatments.aspx

  Treatment includes administering isotonic intravenous fluids to correct dehydration and replacing lost electrolytes with sodium, potassium, magnesium and phosphate supplements. Insulin is administered intravenously to reduce blood glucose and reverse ketoacidosis. […] Treatment includes rapid administration of insulin to bring down blood sugar levels and correction of dehydration using intravenous fluids. Fluids should be given at least 30 to 60 minutes before insulin.

• #35 4 Diabetic Ketoacidosis and HHNS Nursing Care Plans

  https://nurseslabs.com/diabetic-ketoacidosis-nursing-care-plans/

  Without insulin, the amount of glucose entering the cells is reduced, and the production and release of glucose by the liver are increased, leading to hyperglycemia. In an attempt to rid the body of excess glucose, the kidneys excrete the glucose along with water and electrolytes. This osmotic diuresis, which is characterized by excessive urination, leads to dehydration and marked electrolyte loss. […] Diabetic ketoacidosis is an acute complication of diabetes. Around one-third of DKA cases occur in newly diagnosed diabetes mellitus clients. Most deaths are caused by cerebral edema complications. Awareness forms the basis for health-related practices being implemented. Therefore, it is important to assess and update the knowledge and understanding of clients about diabetes and DKA. […] The mainstay of treatment for Diabetic Ketoacidosis (DKA) involves intravenous insulin administration to lower blood glucose levels, intravenous fluids to correct dehydration and electrolyte imbalances, and potassium supplementation to address hypokalemia. In Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS), intravenous fluids are given to restore hydration and normalize blood glucose levels, and insulin therapy may be required to lower blood sugar.

• #36 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diabetic-Coma-Treatments.aspx

  Treatment includes administering isotonic intravenous fluids to correct dehydration and replacing lost electrolytes with sodium, potassium, magnesium and phosphate supplements. Insulin is administered intravenously to reduce blood glucose and reverse ketoacidosis. […] Treatment includes rapid administration of insulin to bring down blood sugar levels and correction of dehydration using intravenous fluids. Fluids should be given at least 30 to 60 minutes before insulin.

• #37 Diabetic coma – Wikipedia

  https://en.wikipedia.org/wiki/Diabetic_coma

  Diabetic coma is a life-threatening but reversible form of coma found in people with diabetes mellitus. […] Treatment depends upon the underlying cause: Hypoglycemic diabetic coma: administration of the hormone glucagon to reverse the effects of insulin, or glucose given intravenously. […] Ketoacidotic diabetic coma: intravenous fluids, insulin and administration of potassium and sodium. […] Hyperosmolar diabetic coma: plenty of intravenous fluids, insulin, potassium and sodium given as soon as possible.

• #38 Med-Surg: Diabetes Complications – Hypoglycemia, DKA, HHS – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-19-diabetes-complications-hypoglycemia-dka-hhs?srsltid=AfmBOoovAnbezQc0YXyC4I9h6iJ6dXz8YSIIfS-3tOUu2jwYBR6Sauyw

  Hypoglycemia is a common complication seen in patients with diabetes wherein blood glucose levels drop below 70 mg/dL. […] The signs and symptoms of hypoglycemia include hunger, irritability, confusion, diaphoresis, headache, shakiness, blurred vision, pale, cool skin, and decreased level of consciousness that can progress into a coma. […] When you have a patient in a hypoglycemic state, your objective is to bring their blood glucose levels back up. The method by which you will do this depends upon if the patient is conscious or unconscious. […] For a patient that is conscious, you will need to quickly provide 15g of a readily-absorbed carbohydrate, like in juice or milk. […] If a patient is unconscious, they arent going to be swallowing any juice, so you will need to inject glucagon through the intramuscular or subcutaneous route.

• #39 Hyperglycemic Emergencies

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/managing-acute-diabetic-complications

  Diabetes mellitus (DM) is a chronic disease that can have very serious acute and life-threatening complications from hypo or hyperglycemia. […] Use this reference guide to assist you in the management of patients experiencing hypoglycemic (low blood glucose) and hyperglycemic (high blood glucose) emergencies. […] A hypoglycemia management protocol is recommended and should include: A standardized, nurse-initiated hypoglycemia treatment protocol to immediately address blood glucose levels less than 70 mg/dL (3.9 mmol/L). […] Management goals are similar and include restoring circulatory volume, euglycemia, and correction of electrolyte imbalance and acidosis. […] It is important to rapidly identify and treat any correctable underlying cause of DKA or HHS. […] Nursing considerations include: Monitor blood glucose every hour until stable.

• #40 Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA) | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-diabetic-ketoacidosis-dka

  Monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature. Conduct a general assessment to identify signs of distress, altered mental status, or other symptoms associated with DKA. […] Regularly assess glycemic control by monitoring blood glucose levels. Evaluate the effectiveness of insulin therapy and adjustments in achieving and maintaining target blood glucose levels within the normal range. […] Assess fluid and electrolyte balance by monitoring laboratory values and clinical indicators. Evaluate the effectiveness of fluid replacement and electrolyte correction interventions, aiming for restoration of normal levels. […] Provide comprehensive education to individuals with diabetes and their caregivers on the prevention of DKA. Emphasize the importance of regular insulin therapy, continuous glucose monitoring, early recognition of signs of DKA, and prompt medical intervention during illness or stress.

• #41 Hyperglycemic Emergencies

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/managing-acute-diabetic-complications

  Diabetes mellitus (DM) is a chronic disease that can have very serious acute and life-threatening complications from hypo or hyperglycemia. […] Use this reference guide to assist you in the management of patients experiencing hypoglycemic (low blood glucose) and hyperglycemic (high blood glucose) emergencies. […] A hypoglycemia management protocol is recommended and should include: A standardized, nurse-initiated hypoglycemia treatment protocol to immediately address blood glucose levels less than 70 mg/dL (3.9 mmol/L). […] Management goals are similar and include restoring circulatory volume, euglycemia, and correction of electrolyte imbalance and acidosis. […] It is important to rapidly identify and treat any correctable underlying cause of DKA or HHS. […] Nursing considerations include: Monitor blood glucose every hour until stable.

• #42 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/

  Nursing interventions are directed at prevention. […] Fluid resuscitation is crucial in the management of patients with DKA. […] Monitor closely for alterations in cognition, posturing, and lethargy as signs of cerebral hypoperfusion. […] Administer isotonic solutions initially. […] To prevent a recurrence of DKA or when to seek prompt treatment, educate the patient on symptoms such as polydipsia, polyuria, nausea and vomiting, flushed skin, weakness, and fatigue.

• #43 The veterinary nurse’s guide to diabetic ketoacidosis — Veterinary Internal Medicine Nursing

  https://www.veterinaryinternalmedicinenursing.com/blog/dka

  Diabetic ketoacidosis (DKA) is a serious complication of unregulated or decompensated diabetes mellitus, which is associated with significant morbidity and mortality. […] DKA patients are challenging but incredibly rewarding to nurse and the veterinary nurse plays a key role in the management and nursing care of these difficult patients. […] The goals of DKA treatment are: To restore circulating fluid volume, To reverse metabolic acidosis, To reduce glucose and ketone levels, To correct any abnormalities. […] DKA patients should be monitored closely, especially in the early stages of treatment. […] Vital parameters should be regularly assessed and the patient monitored closely for signs of dehydration, hypovolaemia and electrolyte abnormalities (such as neck ventroflexion and muscle weakness in the hypokalaemic patient).

• #44 Hyperglycemic Emergencies

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/managing-acute-diabetic-complications

  Assess cardiac, renal, and mental status. […] For DKA patients, when the ketoacidosis and anion gap have resolved and the patient is able to eat, begin a multiple-dose (basal-bolus), subcutaneous insulin schedule. […] For HHS patients, IV insulin infusion can be tapered and a multiple-dose (basal-bolus), subcutaneous insulin schedule may be started when the serum glucose falls below 250-300 mg/dL (13.9 to 16. mmol/L). […] IV insulin should continue for 2 to 4 hours after the first dose of subcutaneous insulin administration to avoid hyperglycemia.

• #45 Hyperglycemic Emergencies

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/managing-acute-diabetic-complications

  Assess cardiac, renal, and mental status. […] For DKA patients, when the ketoacidosis and anion gap have resolved and the patient is able to eat, begin a multiple-dose (basal-bolus), subcutaneous insulin schedule. […] For HHS patients, IV insulin infusion can be tapered and a multiple-dose (basal-bolus), subcutaneous insulin schedule may be started when the serum glucose falls below 250-300 mg/dL (13.9 to 16. mmol/L). […] IV insulin should continue for 2 to 4 hours after the first dose of subcutaneous insulin administration to avoid hyperglycemia.

• #46 The veterinary nurse’s guide to diabetic ketoacidosis — Veterinary Internal Medicine Nursing

  https://www.veterinaryinternalmedicinenursing.com/blog/dka

  Following successful treatment of the ketoacidosis, the patient should be transitioned onto longer-acting insulin and managed as a normal diabetic patient. […] DKA patients give us so much to think about as nurses, and are an ideal opportunity for us to use more practical skills, such as placing sampling lines, calculating and administering CRIs, and interpreting blood gas results. […] And, since after stabilising them well be caring for them as a long-term diabetic, our care doesnt stop when theyre stabilised!

• #47 Ketoacidosis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568717/

  Nursing management roles in a patient with ketoacidosis include monitoring vitals, checking blood sugars and treating with insulin as ordered, starting two large-bore IVs, administering fluids as recommended, checking electrolytes as potassium levels will drop with insulin treatment, checking renal function, assessing mental status, looking for signs of infection, educating the patient on the importance of compliance with diabetic medications, educating the patient on the importance of follow up, checking urine output, encouraging the patient to quit smoking and abstain from alcohol, encouraging a healthy diet, asking the patient to wear an ID bracelet signifying that he or she has had a DKA episode, checking urine and blood cultures, and listening to the lungs for rales and crackles. […] The diabetic nurse should follow all outpatients to ensure medication compliance, follow up with clinicians, and adopt a positive lifestyle. […] The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care.

• #48 Diabetic coma – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475

  A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] If you go into a diabetic coma, you’re alive but you can’t wake up or respond purposefully to sights, sounds or other types of stimulation. If it’s not treated, a diabetic coma can result in death. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] If you’re with someone with diabetes who has passed out, call for emergency help. Tell the emergency personnel that the unconscious person has diabetes. […] Good day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind: Follow your meal plan. Consistent snacks and meals can help you control your blood sugar level.

• #49 Diabetic coma – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475

  Have a sick-day plan. Illness can cause an unexpected change in blood sugar. If you are sick and unable to eat, your blood sugar may drop. […] Check for ketones when your blood sugar is high. Check your urine for ketones when your blood sugar level is over 250 Milligrams per deciliter (mg/dL) (14 Millimoles per litre (mmol/L)) on more than two consecutive tests, especially if you are sick. […] Have glucagon and fast-acting sources of sugar available. If you take insulin for your diabetes, have an up-to-date glucagon kit and fast-acting sources of sugar, such as glucose tablets or orange juice, readily available to treat low blood sugar levels. […] Educate your loved ones, friends and co-workers. Teach loved ones and other close contacts how to recognize the early symptoms of blood sugar extremes and how to give emergency injections. If you pass out, someone should be able to call for emergency help. […] Wear a medical identification bracelet or necklace. If you’re unconscious, the bracelet or necklace can provide valuable information to your friends, co-workers and emergency personnel.

• #50 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/

  Nursing interventions are directed at prevention. […] Fluid resuscitation is crucial in the management of patients with DKA. […] Monitor closely for alterations in cognition, posturing, and lethargy as signs of cerebral hypoperfusion. […] Administer isotonic solutions initially. […] To prevent a recurrence of DKA or when to seek prompt treatment, educate the patient on symptoms such as polydipsia, polyuria, nausea and vomiting, flushed skin, weakness, and fatigue.

• #51 Diabetic coma – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475

  Have a sick-day plan. Illness can cause an unexpected change in blood sugar. If you are sick and unable to eat, your blood sugar may drop. […] Check for ketones when your blood sugar is high. Check your urine for ketones when your blood sugar level is over 250 Milligrams per deciliter (mg/dL) (14 Millimoles per litre (mmol/L)) on more than two consecutive tests, especially if you are sick. […] Have glucagon and fast-acting sources of sugar available. If you take insulin for your diabetes, have an up-to-date glucagon kit and fast-acting sources of sugar, such as glucose tablets or orange juice, readily available to treat low blood sugar levels. […] Educate your loved ones, friends and co-workers. Teach loved ones and other close contacts how to recognize the early symptoms of blood sugar extremes and how to give emergency injections. If you pass out, someone should be able to call for emergency help. […] Wear a medical identification bracelet or necklace. If you’re unconscious, the bracelet or necklace can provide valuable information to your friends, co-workers and emergency personnel.

• #52 How Do You Handle a Diabetic Coma? | West Valley

  https://westvalleymedctr.com/blog/entry/how-do-you-handle-a-diabetic-coma

  If a friend or loved one has diabetes, making sure the condition is properly managed can sometimes be a matter of life or death. […] Here’s what you should know about a diabetic coma regarding risk factors, causes, treatment, and prevention. […] “A coma is a medical emergency. Without any treatment, it can be fatal. So, you want to call 911 right away,” says Greta. […] It’s important to give the 911 dispatcher as much information as possible about your friend or loved one’s condition. […] Making sure your friend or loved one is monitoring her blood sugar is the best way to prevent a diabetic coma. […] Knowing the signs of high or low blood sugar helps, too. […] “It’s always better to recognize the signs earlier rather than later, because then you can treat the symptoms and prevent the emergency,” Greta says.

• #53 Diabetic Ketoacidosis (DKA): Your Guide to Diabetic Coma

  https://www.trifectanutrition.com/health/diabetic-ketoacidosis-dka-guide-to-diabetic-coma?srsltid=AfmBOopYIpotkb0fVrfbCVNHuSP-D-aFxrdp3LiVqMxgaqz7CNWCuF1a

  Diabetic coma is the term used to describe a mental state change in people with diabetes from extreme fluctuations in blood sugar levels. […] Someone with these mental state changes may be confused, have seizures, or be in a state of unresponsive coma. […] A diabetic coma can result from three main causes: Hypoglycemia, Diabetic Ketoacidosis (DKA), Hyperosmolar Hyperglycemic State (HHS). […] DKA treatment requires improving the acidosis, hyperglycemia, and dehydration by carefully giving the right amount of insulin and fluid and fixing dangerous electrolyte abnormalities (in particular correcting potassium levels). […] Because proper management of DKA is so intensive, it often requires hospital admission to the intensive care unit (ICU) for extremely close monitoring and treatment. […] The best ways to prevent diabetic ketoacidosis includes: Frequent blood glucose checks, Well controlled diet, Regulated exercise, Consistent medication. […] Diabetics with positive ketones should always be evaluated by a doctor to ensure they are not in diabetic ketoacidosis.

• #54 Understanding and Preventing Diabetic Coma

  https://www.healthline.com/health/understanding-and-preventing-diabetic-coma

  Diabetic coma is a serious, potentially life-threatening complication associated with diabetes. A diabetic coma causes unconsciousness that you cannot awaken from without medical care. […] Diabetic comas are considered emergencies that require prompt medical attention and are treated in a hospital setting. […] Its important to help instruct your loved ones on how to respond if you progress to a diabetic coma. […] Once a person receives treatment, they can regain consciousness after their blood sugar level is normalized. […] Preventive measures are key to reducing the risk for diabetic coma. […] The power to protect from diabetic coma is in your hands. Know the signs and symptoms that may lead up to a coma, and be prepared to spot problems before they turn into emergencies. Prepare both yourselves and others about what to do if you become comatose. Make sure to manage your diabetes to reduce your risk.

• #55 Diabetic coma – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475

  Have a sick-day plan. Illness can cause an unexpected change in blood sugar. If you are sick and unable to eat, your blood sugar may drop. […] Check for ketones when your blood sugar is high. Check your urine for ketones when your blood sugar level is over 250 Milligrams per deciliter (mg/dL) (14 Millimoles per litre (mmol/L)) on more than two consecutive tests, especially if you are sick. […] Have glucagon and fast-acting sources of sugar available. If you take insulin for your diabetes, have an up-to-date glucagon kit and fast-acting sources of sugar, such as glucose tablets or orange juice, readily available to treat low blood sugar levels. […] Educate your loved ones, friends and co-workers. Teach loved ones and other close contacts how to recognize the early symptoms of blood sugar extremes and how to give emergency injections. If you pass out, someone should be able to call for emergency help. […] Wear a medical identification bracelet or necklace. If you’re unconscious, the bracelet or necklace can provide valuable information to your friends, co-workers and emergency personnel.

• #56 Get the Answer: How Long Can a Diabetic Coma Last?

  https://villageec.com/blog/how-long-can-a-diabetic-coma-last-recovery-prevention-more/

  Another important aspect of diabetic coma prevention is preparation. […] If you are experiencing symptoms of hyper- or hypoglycemia or notice someone becoming unconscious, call 911 and seek professional medical care immediately. Trained medical professionals will be able to evaluate the cause of a diabetic coma and provide necessary treatment for the comatose individual.

• #57 Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA) | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-diabetic-ketoacidosis-dka

  Upon completion of this nursing care plan for Diabetic Ketoacidosis (DKA), nursing students will be able to: […] Recognize the signs and symptoms of Diabetic Ketoacidosis, including hyperglycemia, ketonemia, acidosis, dehydration, and electrolyte imbalances. Acquire the skills to perform a thorough assessment to promptly identify DKA in individuals with diabetes. […] Demonstrate proficiency in implementing rapid and effective nursing interventions for individuals with Diabetic Ketoacidosis. This includes administering insulin, fluid replacement, electrolyte correction, and closely monitoring vital signs and laboratory values. […] Provide education to individuals with diabetes on the prevention of Diabetic Ketoacidosis, emphasizing the importance of insulin management, regular monitoring, recognizing early signs of DKA, and seeking prompt medical attention when needed.

• #58 Understanding and Preventing Diabetic Coma

  https://www.healthline.com/health/understanding-and-preventing-diabetic-coma

  Diabetic coma is a serious, potentially life-threatening complication associated with diabetes. A diabetic coma causes unconsciousness that you cannot awaken from without medical care. […] Diabetic comas are considered emergencies that require prompt medical attention and are treated in a hospital setting. […] Its important to help instruct your loved ones on how to respond if you progress to a diabetic coma. […] Once a person receives treatment, they can regain consciousness after their blood sugar level is normalized. […] Preventive measures are key to reducing the risk for diabetic coma. […] The power to protect from diabetic coma is in your hands. Know the signs and symptoms that may lead up to a coma, and be prepared to spot problems before they turn into emergencies. Prepare both yourselves and others about what to do if you become comatose. Make sure to manage your diabetes to reduce your risk.

• #59 Diabetic Ketoacidosis (DKA): Your Guide to Diabetic Coma

  https://www.trifectanutrition.com/health/diabetic-ketoacidosis-dka-guide-to-diabetic-coma?srsltid=AfmBOopYIpotkb0fVrfbCVNHuSP-D-aFxrdp3LiVqMxgaqz7CNWCuF1a

  Diabetic coma is the term used to describe a mental state change in people with diabetes from extreme fluctuations in blood sugar levels. […] Someone with these mental state changes may be confused, have seizures, or be in a state of unresponsive coma. […] A diabetic coma can result from three main causes: Hypoglycemia, Diabetic Ketoacidosis (DKA), Hyperosmolar Hyperglycemic State (HHS). […] DKA treatment requires improving the acidosis, hyperglycemia, and dehydration by carefully giving the right amount of insulin and fluid and fixing dangerous electrolyte abnormalities (in particular correcting potassium levels). […] Because proper management of DKA is so intensive, it often requires hospital admission to the intensive care unit (ICU) for extremely close monitoring and treatment. […] The best ways to prevent diabetic ketoacidosis includes: Frequent blood glucose checks, Well controlled diet, Regulated exercise, Consistent medication. […] Diabetics with positive ketones should always be evaluated by a doctor to ensure they are not in diabetic ketoacidosis.

• #60 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/

  Nursing interventions are directed at prevention. […] Fluid resuscitation is crucial in the management of patients with DKA. […] Monitor closely for alterations in cognition, posturing, and lethargy as signs of cerebral hypoperfusion. […] Administer isotonic solutions initially. […] To prevent a recurrence of DKA or when to seek prompt treatment, educate the patient on symptoms such as polydipsia, polyuria, nausea and vomiting, flushed skin, weakness, and fatigue.

• #61 Diabetic coma – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475

  A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] If you go into a diabetic coma, you’re alive but you can’t wake up or respond purposefully to sights, sounds or other types of stimulation. If it’s not treated, a diabetic coma can result in death. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] If you’re with someone with diabetes who has passed out, call for emergency help. Tell the emergency personnel that the unconscious person has diabetes. […] Good day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind: Follow your meal plan. Consistent snacks and meals can help you control your blood sugar level.

• #62 Diabetic Coma: Causes, Symptoms & Treatments

  https://www.megawecare.com/good-health-by-yourself/diabetes/diabetic-coma-causes-symptoms-treatments

  Diabetic ketoacidosis which can lead to diabetic coma is one of the most lethal complications of diabetes. […] Diabetic ketoacidosis can lead to diabetic coma, resulting in brain damage and even death. […] Poor diabetes management, skipping meals, and insulin are some causes. […] You can prevent diabetic coma by taking appropriate steps such as following a treatment plan, a healthy diet, and exercise.

• #63 Ketoacidosis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568717/

  Nursing management roles in a patient with ketoacidosis include monitoring vitals, checking blood sugars and treating with insulin as ordered, starting two large-bore IVs, administering fluids as recommended, checking electrolytes as potassium levels will drop with insulin treatment, checking renal function, assessing mental status, looking for signs of infection, educating the patient on the importance of compliance with diabetic medications, educating the patient on the importance of follow up, checking urine output, encouraging the patient to quit smoking and abstain from alcohol, encouraging a healthy diet, asking the patient to wear an ID bracelet signifying that he or she has had a DKA episode, checking urine and blood cultures, and listening to the lungs for rales and crackles. […] The diabetic nurse should follow all outpatients to ensure medication compliance, follow up with clinicians, and adopt a positive lifestyle. […] The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care.

• #64 Nurses’ Experiences in Caring Diabetic Ketoacidosis Patients in the Emergency Departments: A Qualitative Study

  https://clinmedjournals.org/articles/ijccem/international-journal-of-critical-care-and-emergency-medicine-ijccem-10-166.php?jid=ijccem

  Some participants thoughtful concern regards the clarity of roles highlighting a potential issue of overlap in responsibilities between doctors and nurses, prompting them to question the specific duties assigned to nursing staff within available comprehensive DKA protocol. […] The interaction between healthcare providers and patients can be influenced by various cultural and religious beliefs. […] This study explored the DKA patients’ management experiences among nurses working in the emergency medical department from regional referral hospitals. […] Variability in nursing interventions for DKA management and clinical challenges were major themes emerged. […] These findings underscore the urgent need for standardized training, improved adherence to protocols, and the integration of point-of-care testing to enhance timely and effective DKA management.

• #65 4 Diabetic Ketoacidosis and HHNS Nursing Care Plans

  https://nurseslabs.com/diabetic-ketoacidosis-nursing-care-plans/

  Use this nursing care plan and management guide to provide care for patients with diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome. Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals with diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome. […] The nursing care plan for clients with Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome includes the provision of information about the disease process/prognosis, self-care, and treatment needs, monitoring and assistance of cardiovascular, pulmonary, renal, and central nervous system (CNS) function, avoiding dehydration, and correcting hyperglycemia and hyperglycemia complications.

• #66

  https://lettersinhighenergyphysics.com/index.php/LHEP/article/view/1109

  Caring for patients in a diabetic coma requires immediate and comprehensive nursing interventions to address critical needs and prevent further complications. Initial assessments should include monitoring vital signs, blood glucose levels, and neurological status. Nurses must establish intravenous access for fluid replacement, electrolytes, and insulin therapy as prescribed. Frequent assessments are crucial to evaluate the patients response to treatment and to detect signs of potential complications, such as hypoglycemia or fluid overload. Patient safety must also be prioritized, which includes positioning the patient to maintain airway patency and implementing seizure precautions if necessary. In addition to medical management, providing emotional support and education to both the patient (when conscious) and their family is essential. Nurses should explain the nature of diabetic coma and the importance of ongoing diabetes management, including lifestyle modifications and adherence to medication regimens to prevent future episodes. Collaborating with a multidisciplinary team, including dietitians and diabetes educators, enhances patient care and promotes holistic recovery. Continuous nursing education on emerging practices and innovations in diabetes management can further empower nursing staff to deliver effective care to diabetic coma patients.

• #67 Studying the Role of Nurses in the Diabetic Ketoacidosis Management – Journal of Integrative Nursing and Palliative Care

  https://journalinpc.com/article/studying-the-role-of-nurses-in-the-diabetic-ketoacidosis-management-wpgdjuodfmcqalc

  Nurses have a role in the diagnosis, assessment, and management of diabetic ketoacidosis. […] Effective roles include maintaining fluid and electrolyte balance, setting the patient’s insulin dose, and sketching a discharge plan to exclude DKA recurrence. […] Management of ketoacidosis is an interdisciplinary team effort in which nurses play a key role in controlling, identifying, and prohibiting the progression and symptoms recurrence. […] For the effective management of ketoacidosis, the use of skilled and knowledgeable nurses is essential.

• #68 Nurses’ Experiences in Caring Diabetic Ketoacidosis Patients in the Emergency Departments: A Qualitative Study

  https://clinmedjournals.org/articles/ijccem/international-journal-of-critical-care-and-emergency-medicine-ijccem-10-166.php?jid=ijccem

  Some participants thoughtful concern regards the clarity of roles highlighting a potential issue of overlap in responsibilities between doctors and nurses, prompting them to question the specific duties assigned to nursing staff within available comprehensive DKA protocol. […] The interaction between healthcare providers and patients can be influenced by various cultural and religious beliefs. […] This study explored the DKA patients’ management experiences among nurses working in the emergency medical department from regional referral hospitals. […] Variability in nursing interventions for DKA management and clinical challenges were major themes emerged. […] These findings underscore the urgent need for standardized training, improved adherence to protocols, and the integration of point-of-care testing to enhance timely and effective DKA management.

• #69 Nurses’ Experiences in Caring Diabetic Ketoacidosis Patients in the Emergency Departments: A Qualitative Study

  https://clinmedjournals.org/articles/ijccem/international-journal-of-critical-care-and-emergency-medicine-ijccem-10-166.php?jid=ijccem

  Conclusion: These findings underscore the urgent need for standardized training, design strategies to improved adherence to DKA management protocols, and the integration of point-of-care testing (POCT) to enhance timely and effective DKA management. […] While many nurses successfully managed DKA by adhering to established guidelines, some faced challenges due to gaps in their comprehensive knowledge of DKA management. […] Therefore, this theme describes nurses’ experiences when managing DKA where theme three sub-themes were identified: Correction of Dehydration, Correction of hyperglycemia and Correction of Electrolyte imbalance. […] The majority of nurses who participated in this study discussed mixed of responses regarding the amount of fluid to be used, type of fluid and time interval of fluid administration when managing patient with DKA at Emergency department. […] Surprisingly, some participants responded that the measured level of RBG determined the amount of fluid that DKA patient to be administered contrary to the available management protocol.

• #70

  https://lettersinhighenergyphysics.com/index.php/LHEP/article/view/1109

  Caring for patients in a diabetic coma requires immediate and comprehensive nursing interventions to address critical needs and prevent further complications. Initial assessments should include monitoring vital signs, blood glucose levels, and neurological status. Nurses must establish intravenous access for fluid replacement, electrolytes, and insulin therapy as prescribed. Frequent assessments are crucial to evaluate the patients response to treatment and to detect signs of potential complications, such as hypoglycemia or fluid overload. Patient safety must also be prioritized, which includes positioning the patient to maintain airway patency and implementing seizure precautions if necessary. In addition to medical management, providing emotional support and education to both the patient (when conscious) and their family is essential. Nurses should explain the nature of diabetic coma and the importance of ongoing diabetes management, including lifestyle modifications and adherence to medication regimens to prevent future episodes. Collaborating with a multidisciplinary team, including dietitians and diabetes educators, enhances patient care and promotes holistic recovery. Continuous nursing education on emerging practices and innovations in diabetes management can further empower nursing staff to deliver effective care to diabetic coma patients.

• #71 The veterinary nurse’s guide to diabetic ketoacidosis — Veterinary Internal Medicine Nursing

  https://www.veterinaryinternalmedicinenursing.com/blog/dka

  Diabetic ketoacidosis (DKA) is a serious complication of unregulated or decompensated diabetes mellitus, which is associated with significant morbidity and mortality. […] DKA patients are challenging but incredibly rewarding to nurse and the veterinary nurse plays a key role in the management and nursing care of these difficult patients. […] The goals of DKA treatment are: To restore circulating fluid volume, To reverse metabolic acidosis, To reduce glucose and ketone levels, To correct any abnormalities. […] DKA patients should be monitored closely, especially in the early stages of treatment. […] Vital parameters should be regularly assessed and the patient monitored closely for signs of dehydration, hypovolaemia and electrolyte abnormalities (such as neck ventroflexion and muscle weakness in the hypokalaemic patient).

• #72 Studying the Role of Nurses in the Diabetic Ketoacidosis Management – Journal of Integrative Nursing and Palliative Care

  https://journalinpc.com/article/studying-the-role-of-nurses-in-the-diabetic-ketoacidosis-management-wpgdjuodfmcqalc

  Nurses have a role in the diagnosis, assessment, and management of diabetic ketoacidosis. […] Effective roles include maintaining fluid and electrolyte balance, setting the patient’s insulin dose, and sketching a discharge plan to exclude DKA recurrence. […] Management of ketoacidosis is an interdisciplinary team effort in which nurses play a key role in controlling, identifying, and prohibiting the progression and symptoms recurrence. […] For the effective management of ketoacidosis, the use of skilled and knowledgeable nurses is essential.

• #73 Ketoacidosis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568717/

  Nursing management roles in a patient with ketoacidosis include monitoring vitals, checking blood sugars and treating with insulin as ordered, starting two large-bore IVs, administering fluids as recommended, checking electrolytes as potassium levels will drop with insulin treatment, checking renal function, assessing mental status, looking for signs of infection, educating the patient on the importance of compliance with diabetic medications, educating the patient on the importance of follow up, checking urine output, encouraging the patient to quit smoking and abstain from alcohol, encouraging a healthy diet, asking the patient to wear an ID bracelet signifying that he or she has had a DKA episode, checking urine and blood cultures, and listening to the lungs for rales and crackles. […] The diabetic nurse should follow all outpatients to ensure medication compliance, follow up with clinicians, and adopt a positive lifestyle. […] The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care.

• #74 4 Diabetic Ketoacidosis and HHNS Nursing Care Plans

  https://nurseslabs.com/diabetic-ketoacidosis-nursing-care-plans/

  Goals and expected outcomes may include: The client will remain normovolemic as evidenced by urinary output greater than 30 ml/hr, normal skin turgor, good capillary refill, normal blood pressure, palpable peripheral pulses, and blood glucose levels between 70-200 mg/dL. The client will display normal electrolyte levels and stable vital signs. The client will be free of infection as evidenced by normothermia, HR of 100 beats/minute or less, BP within the clients normal range, WBC count of 11,000/mm or less, and negative culture results. The client will identify interventions to prevent and reduce the risk of infection. The client will demonstrate techniques, and lifestyle changes to prevent the development of infection. The client will display a normal energy level. The client will take appropriate amounts of calories/nutrients. The client will demonstrate stabilized weight or gain toward desired range with normal laboratory values. The client will maintain a blood glucose level in the satisfactory range. The client will acknowledge the factors that lead to unstable blood glucose and DKA. The client will verbalize understanding of body and energy needs. The client will verbalize a plan for modifying factors to prevent or minimize complications.

• #75

  https://link.springer.com/article/10.1007/BF02581403

  A brief review of some therapy results in 763 episodes of diabetic coma from 1960 to 1973 reveals a significant decrease in lethality after institution of an intensive care unit. […] Present aspects of management are: intensification of shock therapy, potassium substitution and treatment of cerebral edema. […] The lowering of the as yet high lethality of diabetic coma is an urgent necessity. […] Intensive Care in the Management of Diabetic Ketoacidosis.

• #76 Get the Answer: How Long Can a Diabetic Coma Last?

  https://villageec.com/blog/how-long-can-a-diabetic-coma-last-recovery-prevention-more/

  A diabetic coma is a medical emergency wherein an individual will lose consciousness as a result of an imbalance in their insulin and glucose levels. […] Diabetic comas are medical emergencies, and require immediate medical attention. If someone you love is in a diabetic coma, do not try to wake them up on your own or wait for them to naturally come out of the coma. The only way to come out of a diabetic coma is to return blood glucose levels to a healthy range, which can only be done by a medical professional. […] Individuals who receive professional medical treatment for their diabetic coma typically make full recoveries. […] During the recovery process, your doctor may make some suggestions to help prevent a diabetic coma in the future. […] Diabetic coma prevention mainly involves the frequent monitoring of your blood sugar levels in order to avoid hyperglycemia, hypoglycemia, or DKA.

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