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Answer :
(a) The Electrolytes monitored in the acute stage of DKA is; Potassium, Sodium, Chloride. (b) Electrolyte imbalances in DKA are corrected through appropriate fluid and electrolyte replacement. (c) Correction of acid-base disturbances in DKA is achieved through insulin therapy.
In the acute stage of diabetic ketoacidosis (DKA), the following electrolytes are typically monitored;
Potassium (K⁺); Potassium levels are closely monitored because DKA is associated with total body potassium depletion. As insulin deficiency and acidosis are corrected during treatment, there can be a shift of potassium from the extracellular space back into the cells, which can lead to a potentially dangerous drop in blood potassium levels (hypokalemia).
Sodium (Na⁺): Sodium levels are monitored as derangements can occur due to the osmotic effects of hyperglycemia and dehydration. In DKA, sodium levels may be initially diluted due to extracellular fluid volume depletion.
Chloride (Cl⁻): Chloride levels are monitored as imbalances can occur alongside sodium and fluid shifts. Monitoring chloride levels helps assess the acid-base balance and guide appropriate management.
Correction of electrolyte imbalances;
Electrolyte imbalances in DKA are corrected through appropriate fluid and electrolyte replacement. Intravenous fluids containing saline (0.9% sodium chloride) are typically administered to restore hydration and correct electrolyte imbalances. Potassium supplementation may also be necessary to prevent or treat hypokalemia.
The rate at which electrolyte imbalances are corrected depends on the severity of the imbalances and the individual patient's condition. It is important to correct electrolyte imbalances gradually to avoid rapid shifts that can lead to complications such as cardiac arrhythmias.
Monitoring and correction of acid-base disturbances;
Acid-base disturbances, particularly metabolic acidosis, are monitored in DKA. This is typically assessed by measuring arterial blood gases, including pH, bicarbonate levels (HCO₃⁻), and the partial pressure of carbon dioxide e (PaCO₂).
Correction of acid-base disturbances in DKA is achieved through insulin therapy, which helps reverse ketone body formation and metabolic acidosis. As insulin therapy improves the underlying metabolic derangements, acidosis gradually resolves.
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