The mother tells you the following:

Question

"Blood glucose monitor has been reading ‘high.'"
"C.J. has had sips of ginger ale, but that's all."
"She has been vomiting about every other time she drinks.

"
"When she first got home, she went [voided] a lot, but yesterday she hardly went at all, and I don't
think she has gone today."
"She went to bed early last night, and I could hardly wake her up this morning. that's why I brought
her in."
Describe the pathophysiology of diabetic ketoacidosis (DKA).

Answer 1

DKA occurs as the result of a relative lack of insulin leading to the body's increase in metabolism
in a less efficient attempt to use other sources for energy. The result is burning of lipids from fat
stores. Ketones are formed because of lipolysis, and metabolic acids are produced. Serum osmolality
increases slightly, drawing fluid and Na from cells, resulting in dehydration and increased urinary
output. Blood lactate levels rise, further complicating the acidosis. The most common causes are
underlying infection, disruption of insulin treatment, and new- or initial-onset DM.