DKA happens when insufficient insulin forces cells to burn fat, producing acidic ketones. Watch mental status closely because fluid shifts can increase intracranial pressure and cause cerebral edema. NCLEX tests IV fluid choices: normal saline, lactated Ringer's, 0.45% saline, and 5% dextrose in half-normal saline.
Lets walk through some key NCLEX points for diabetic ketoacidosis. So what's happening here is there's not enough insulin in the body for glucose to be used by the cells for energy, so they use fat instead. And the problem with this is that fat produces ketones, and ketones are acid. So the acid is going to rise in the body. Now, some key key NCLEX points to know here is to monitor for mental status changes because of increased intracranial pressure. As that blood glucose level decreases, fluid can shift and cause that fluid to shift into the cerebral spinal fluid in the brain, which can cause cerebral edema. So watch for those mental status changes for increased intracranial pressure. The NCLEX also loves to test you on your nursing interventions for this. So you're going to give IV fluids as prescribed, normal saline or lactated ringers, then SER, 0.45% normal saline, 5% dextrose in half normal.
