Initial evaluation (perform immediately): ‘Histor and physical amination «Laboratory tess: arterial blood gases, complete blood count with diferent, tna, blood elucse, bod urea nitrogen, cestnne, electri (chem 7) ‘+ lecrecariogram + Chestadogeaph and cuts 28 needed « Star I fluid: Lof 0.9% sodium chloide per hour initial (15 1020 t/kgyhou) Diagnostic citeria for diabetic ketoacidosis: + Blood glucose level >250 mg/dl (13.9 mre) * Anerial pH <7.3 * Seu babar oe <15 még *Nedeote eon ved fone wits vs peas Deter aon sats sem pasion els wesae somfoue "<3 ne hol ln 1 ded ge tO mea ‘Potassium per hour (Two ‘Hypovolemic Mild Cardiogeric Acmirister regular —_Adrrinister regular insulin, thirds as potassium ‘tock hypotension shock insulin, 0.15 U/kg 0.3 Ukg, with one half chloride andone thed 3s eV bous ghen atV beusand ove fotaium phase) | haf given SC or M ‘until potassium levels Adriiter Henaxjnamic 233 mEgh 09% san rong | clonde Adrinterreyor Anise eg (1 Unow) insulin, 0.1 Wkghour insulin, 0.1 U/kg/hour If serum potassium level is andor plasma lV infusion $C oF IM 25.5 mEq, donot give eede potasivn bat ec le bey? tous Wicd ghcrs eel oe rtf by $010 70 gg AF al sroate creat seum sod ee 281039 nme) in esos Fyn pied ——__| ‘gre 20 te 30 miqef prism eae er Seuetodun Set soda Sewn sum Wb uninfsin Ghehouy 160 ean nde nd ‘calnah” “pelaomal liu” Pow urtl Sood ilnbos nl nr: ores Suedeloefas ty Dendaucrlea tas, EIN PIN SMe7omgdl—sDwTmya— maN lee iter 9% om someon ier 045% sodum cnt P1014 CNoide(7 » WL ghou), ido depending ‘depending on hydration status on hydration status ‘When serum glucose reaches 250 mgd. (13.9 mma): Change to 5% dextrose in 0.45% salve administered at ——> Check chem 7 every 2t0 4 heurs untl patient is stable 100 to 200 mUhour, with adequate nsuin (0.05 t000.1 Look agai for precipitating causes ‘Utgfhour as IV infusion or 10 U SC every 2 hours) given —_—_fter resolution of diabetic ketoacidosis, obtain blood lucase to keep blood glucose level between 150 ard 200 mg/dL level every 4 hours, and give slicing cae regular insuin $C (@.3 and 11.1 mmelA) untl metabolic contol is achieved in $-Uinciements for every 0 mg/d. increase above 150 ‘mgj4L.to maximum of 20