NGN Case Study: DKA Walkthrough
DKA presentation through treatment via unfolding case study.
DKA case studies test fluid, insulin, K+ management.
Presentation
19 y/o T1DM. Glucose 480. pH 7.18, HCO3 12, K+ 3.2. Kussmaul. Confused. 2 days no insulin.
Recognize
Hyperglycemia, acidosis, low K+, mental status change.
Analyze
DKA with hypokalemia.
Prioritize
Replace K+ before starting insulin (K+ would drop dangerously with insulin).
Take action
Fluid bolus, K+ replacement, then insulin drip. D5 when BG ~250 to keep insulin going until gap closes.
Evaluate
Anion gap closing, mental status improving, K+ stable, BG controlled.
Frequently asked
When transition to SQ insulin?
Anion gap closed, patient eating, overlap IV-SQ 1-2h.
Quick check
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