[go: up one dir, main page]
Scribd
Upload
58 views2 pages

DKA Adult Admission Orders Guide

This document provides admission orders for treating a patient with diabetic ketoacidosis (DKA). The orders include placing the patient on a DKA pathway, monitoring activity and diet, ordering initial and follow up labs, prescribing IV fluids and adjustments based on lab results, monitoring blood glucose levels hourly, starting an insulin drip if blood glucose is below 250, monitoring intake and output, taking vital signs frequently until DKA is resolved based on lab criteria, consulting diabetes education, and providing prn medications for pain, nausea, sleep and bowel regularity. The orders are aimed at stabilizing the patient's condition and resolving the DKA through fluid resuscitation and insulin therapy while closely monitoring their labs and vital signs.

Uploaded by

Gusti Agung Eka Pridayanti
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
58 views2 pages

DKA Adult Admission Orders Guide

This document provides admission orders for treating a patient with diabetic ketoacidosis (DKA). The orders include placing the patient on a DKA pathway, monitoring activity and diet, ordering initial and follow up labs, prescribing IV fluids and adjustments based on lab results, monitoring blood glucose levels hourly, starting an insulin drip if blood glucose is below 250, monitoring intake and output, taking vital signs frequently until DKA is resolved based on lab criteria, consulting diabetes education, and providing prn medications for pain, nausea, sleep and bowel regularity. The orders are aimed at stabilizing the patient's condition and resolving the DKA through fluid resuscitation and insulin therapy while closely monitoring their labs and vital signs.

Uploaded by

Gusti Agung Eka Pridayanti
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

Diabetic Ketoacidosis (DKA) Adult Clinical Pathway:

Admission Orders
(Page 1 of 2)
ALLERGIES: _______________________
1)

Place patient on DKA Pathway

2)

Activity: __________________________________________________________________

3)

Diet: NPO except noncaloric clear liquids; begin _________ cal diet when DKA resolved
and subcutaneous insulin has been resumed.

4)

EKG if over age 40 or as indicated.

5)

Labs Initial:
____CMP, CBC with differential, lipid profile, venous pH, Hemoglobin A1C, &
urinalysis, unless done in ER.
____If temp >101 F or >20% Bands present in CBC, blood cultures x 2, urine
C&S,
and Chest X-ray
____ Other Labs: __________________________________________________
Lab Follow up till DKA resolved (CO2 >18 or Venous pH >7.3 or Anion Gap <14)
___ BMP Q 6 hrs
___
Phosphorus
___ Venous pH Q 6 hr
___ Anion gap Q 6 hr

6)

IV Fluids (Initial):
___1 or ___2 liters of normal saline (NS) over 2-4 hour followed by
___NS with _____KCl/L at 250cc/hr or _____cc/hr if corrected serum Na is
<132 mEq/l
___1/2 NS with _____KCl/L at 250cc/hr or ____cc/hr if corrected serum Na is
>132 mEq/l
7)

IV Fluids once BG < 250 mg/dl:


_____D51/2 NS with _____ KCl/L IV at 250cc/hr or ___cc/hr

8)

Adjust K orders below based on q 6 hr serum K result (report in BMP results)


Hold insulin if K < 3.2, give KCL ___10 or ___-20 meq/hr x 2 hours
For K < 4.5, add 40 mEq KCL per liter IVF or _____________________
For K 4.6-5.5, add 20 mEq KCL per liter IVF or _____________________
For K > 5.6, hold KCL and check serum K q 2hr

9)

For pH < 6.9, add 2 amps NaHCO3 to D5W or 1/4NS (for adults only)
(do not add NaHCO3 to fluids containing Insulin)

10)

BG per fingerstick on arrival to unit and q 1h unless otherwise specified

11)

Insulin delivery procedure:


1

_____ IV Insulin drip (use Insulin Drip Orders per hospital protocol for target BG 90 to
140
mg/dL including transition to subQ insulin)
12)12) I & O
13)

Vital signs q 2 hr X 4 or until DKA resolved then q 4hr


(DKA resolved when CO2 >18 or Venous pH >7.3 or Anion Gap <14)

14)

Diabetes Education consult for diabetes self management education

154)

Tylenol (Acetaminophen) 650 mg PO q 4-6hr prn pain or __________

165)

MOM or _______ prn laxative

176)

Reglan (Metoclopramide)10 mg IV q 6hr prn nausea or __________________________

187)

Restoril (Temazepam) 15 mg po or ________________________________hs prn sleep

198)

Other Medications: ________________________________________


________________________________________
________________________________________
________________________________________
________________________________________

19)

I&O

20)
<14)

Vital signs q 2 hr X 4 or until DKA resolved (CO2 >18 or Venous pH >7.3 or Anion Gap
then q 4hr

2202) Old chart to floor


213) Other Orders:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Time:______ Date: _______ MD Signature________________________________________

You might also like