Pathophysiology of Diabetic Ketoacidosis: Enhancing Knowledge and Evidence-Based Nursing Practice

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ABSTRACT
The following discusses about the pathophysiology of diabetic ketoacidosis which is a serious
disease leading to ketone bodies buildup in the blood system. It is incumbent upon the
registered nurses to enhance their knowledge and learning skills and incorporate the evidence-
based nursing practice to improve the patient health and management of the disease. It is
INTRODUCTION
Diabetic ketoacidosis (DKA)results from increase in the levels of ketone bodies in the blood system
due to deficiency of insulin which causes insulin to move from blood into the liver. The rise of glucose
levels in blood system is the cause for the lipolysis or break down of free fatty acids in liver, thereby
releasing energy with the formation of keto acids like beta-hydroxy butyric acid and acetoacetic acid
(Soto-Rivera et al., 2017). This in turn leads to metabolic acidosis which causes reduction in blood
pH.The patient condition becomes serious due in response to metabolic ketoacidosis which is the major
focus area for the health care professionals, particularly registered nurses to assess and intervene the
clinical condition and bring about improvement in patient’s health through their enhancement of
knowledge and incorporating evidence-based nursing practice in critical care improvement.
DISCUSSION
The efficient treatment of DKA begins with complete knowledge of the pathophysiology of the
disease. The registered nurses have a crucial role to play in this scenario. The registered nurses need to
have a wide knowledge of the combination of drugs that can yield positive outcomes for patients. In
case of a deteriorating patient, the concern becomes critical; the registered nurses should intervene to
assess the deteriorating patient and identify the deterioration through a rapid response system. The
registered nurses need to make collaborative efforts with ICU liaison nurses to involve rapid response
team and incorporate medical emergency responsibilities(Safetyandquality.gov.au, 2019). The ethical

and legal concerns should be given priority while providing critical care approach to these deteriorating
patients. The Code of Ethics, Quality of care policies, confidentiality policies and Right based patient
constitutions should be incorporated as ethical and legal considerations. The registered nurses should
have a prior knowledge of complementary therapies and effective treatment combinations that would
enable a patient to recover from deteriorating symptoms.Dapagliflozin, incombination with insulin can
be used as effectively to improve the acidosis conditions in patients (Storgaard et al., 2016).
CONCLUSION
It is incumbent on the registered nurses to advance their knowledge about the disease pathophysiology
prior to treating the deteriorating patients. The registered nurses should enhance their knowledge on
rapid response system administration. They should provide clear communication with the response
team and include collaborative strategies during rapid response management. The ethical and legal
policies in patient centered care in critical care environment should be considered by registered
nurses.The national medicines policy should be followed by registered nurses in response to providing
effective drugs that are needed to improve the deteriorating symptoms.The medical emergency criteria
of airway obstructions, circulatory problems, and neurological problems should be checked for calling
rapid response team. The registered nurses should include pharmacokinetic treatment strategies like
combination of drugs to treat diabetic ketoacidosis.
REFERENCE LIST
Adachi, J., Inaba, Y., & Maki, C. (2017). Euglycemic diabetic ketoacidosis with persistent
diuresis treated with canagliflozin. Internal Medicine, 56(2), 187-190.
Al-Ghamdi, A. H., Fureeh, A. A., Alghamdi, J. A., Alkuraimi, W. A., Alomar, F. F., Alzahrani,
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