In last weeks episode, we discussed the differences between DKA and HHS. Today, we'll be sharing how to manage these two diseases.
If you missed last weeks episode, you can listen to that here: https://medgeeks.co/podcast/)
We had that 35 year old female with type 1 DM on insulin complaining of burning with urination, followed by a few days of nausea, vomiting, abdominal pain, and poor PO intake.
Labs revealed DKA: glucose 480, HA1c 10.5%, positive urine/serum ketones, creatinine 1.6, and anion gap of 25.
ABG showed ph of 7.25, PCO2 of 28, bicarb of 12, and O2 of 90 on room air. This is a metabolic acidosis with respiratory compensation.
(We'll also show you a shortcut on how to calculate the expected compensation).
Sodium was 136.
UA was positive for infection.
Vitals: BP 83/45 - MAP of 58, HR 110, 100.8 F.
Management can be grouped into 3 categories:
fluids and electrolytes
insulin
monitor
Today, we'll break this all down for you. Enjoy!
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