DKA QUIZ

Which of the following best describes the pathophysiology of DKA?

• Insulin deficiency leads to excessive glucose uptake into cells, increasing ketone production.

• A lack of insulin causes glucose to accumulate in the blood, triggering fat breakdown and acid buildup.

• The pancreas produces excess insulin, which leads to an overproduction of ketones and metabolic acidosis.

• A sudden spike in insulin levels causes hyperglycemia and dehydration, leading to ketoacidosis.

Why did Ethan's missed insulin doses contribute to DKA?

• Without insulin, glucose cannot enter cells, leading the body to use fat for energy, producing excess ketones.

• Skipping insulin causes dehydration, which directly leads to acidosis and ketone buildup.

• Insulin prevents blood glucose from dropping too low, so missing doses leads to excessive glucose uptake by cells.

• Insulin is not necessary during illness since glucose levels naturally decrease when appetite is reduced.

What is insulin's primary role in reversing DKA?

• It stimulates glucose reabsorption by the kidneys, reducing ketone production.

• It inhibits lipolysis, allowing glucose uptake into cells and stopping ketone production.

• It prevents potassium loss by shifting potassium into the bloodstream, stabilizing acid-base balance.

• It neutralizes ketones directly by binding to free fatty acids in the liver.

Why is potassium closely monitored when treating DKA?

• Insulin therapy increases potassium excretion through the kidneys, causing life-threatening hyperkalemia.

• Insulin shifts potassium into cells, which can cause hypokalemia and lead to cardiac arrhythmias

• The presence of ketones signals a severe potassium excess, requiring immediate potassium restriction.

• Hyperkalemia is not common in DKA, so potassium levels remain stable during treatment.

A patient with DKA arrives in the ER. What is the most urgent nursing intervention?

• Start an insulin IV bolus to rapidly lower blood glucose.

• Give sodium bicarbonate to correct metabolic acidosis immediately.

• Administer IV fluids first to stabilize blood pressure and perfusion.

• Initiate a high-carbohydrate diet to restore glucose levels.

What is the most important teaching point for preventing DKA in patients with Type 1 Diabetes?

• Increase insulin doses when feeling well to build a reserve in the body.

• Reduce insulin when sick to prevent hypoglycemia due to lower food intake.

• Monitor blood glucose and ketones closely during illness and adjust insulin doses accordingly.

• Drink large amounts of water instead of taking insulin to dilute glucose levels.

What is the primary reason ABG analysis is performed in suspected DKA cases?

• To confirm metabolic acidosis by measuring pH and bicarbonate levels.

• To assess kidney function and determine the extent of dehydration.

• To check for electrolyte imbalances, specifically sodium and potassium.

• To determine the patient’s blood glucose level with higher accuracy than a standard glucose test.

A patient with suspected DKA has the following lab results:

Blood glucose: 30 mmol/L, pH: 7.10, HCO₃⁻: 8MeQ/L and Serum ketones: Positive.

What do these findings indicate?

• The patient is in a hypoglycemic crisis with metabolic alkalosis.

• The patient has uncontrolled hyperglycemia with respiratory acidosis.

• The patient has severe metabolic acidosis due to excessive ketone production.

• The patient has dehydration-induced ketosis without acidosis.

What is the most effective long-term strategy for preventing recurrent DKA?

• Strict carbohydrate restriction to avoid glucose fluctuations.

• Routine blood glucose and ketone monitoring, insulin adjustments as needed, and sick-day planning.

• Only taking insulin when blood glucose exceeds 15 mmol/L to prevent overcorrection.

• Avoiding insulin pumps due to increased risk of hyperglycemia.

A patient with Type 1 Diabetes is struggling to afford insulin. What is the best approach for a healthcare provider to take?

• Encourage reducing insulin doses on non-meal days to conserve supply.

• Recommend spacing out insulin doses by taking a higher dose once a day instead.

• Suggest using expired insulin in small amounts to prolong its use.

• Provide education on patient assistance programs and affordable insulin options.