Ketoacidosis Nursing StatPearls NCBI Bookshelf

The condition is an acute form of metabolic acidosis, a condition in which there is too much acid in body fluids. alcoholic ketoacidosis is the buildup of ketones in the blood due to alcohol use. Ketones are a type of acid that form when the body breaks down fat for energy. The nurse practitioner, pharmacist, primary care provider, and an endocrinologist should educate the patient on glucose control at every opportunity.

alcoholic ketoacidosis

Laboratory studies show a serum bicarbonate of 10 mEq/L, an anion gap of 30, a serum glucose of 95 mg/dL, a lactic acidosis with pH 7.2, hypophosphatemia, and trace ketonuria. He denies a history of diabetes mellitus, ingestion of any toxic alcohols, or recent illness. Once the diagnosis of (AKA) is established, the mainstay of treatment is hydration with 5% dextrose in normal saline (D5 NS) to address the principal physiologic derangement, a lack of metabolic substrate (glucose). Carbohydrate and fluid replacement reverse this process by increasing serum insulin levels and suppressing the release of glucagon and other counterregulatory hormones and by providing metabolic substrate. Dextrose stimulates the oxidation of the reduced form of nicotinamide adenine dinucleotide (NADH) and aids in normalizing the ratio of NADH to nicotinamide adenine dinucleotide (NAD+).

Differential Diagnosis

Joining a local chapter of Alcoholics Anonymous may provide you with the support you need to cope. You should also follow all of your doctor’s recommendations to ensure proper nutrition and recovery. If you or someone else has symptoms of alcoholic ketoacidosis, seek emergency medical help.

  • Acute pancreatitis is inflammation that resolves both clinically and histologically.
  • It can be helpful to understand the basic guidelines for alcohol consumption so you can determine whether you are drinking above recommended levels and engaging in potentially harmful alcohol use.
  • (Malnutrition also includes overnutrition.) Undernutrition can result from inadequate ingestion of nutrients, malabsorption, impaired metabolism, loss…
  • Patients are usually tachycardic, dehydrated, tachypneic, present with abdominal pain, and are often agitated.
  • Efficient and timely management can lead to enhanced patient outcomes in patients with AKA.
  • The classical presentation is of an alcoholic patient with abdominal pain and intractable vomiting following a significant period of increased alcohol intake and starvation.

Visit a hospital for emergency medical care and consider a treatment facility to treat alcoholism. If you need help talking to a loved one, look into family resources for alcohol addiction treatment. You can prevent alcoholic ketoacidosis by limiting your alcohol intake. You can learn how to reduce your alcohol intake or eliminate it altogether.

Ethanol metabolism

Fat cells begin breaking down, producing compounds called ketones. Ketones provide some energy to cells but also make the blood too acidic (ketoacidosis). This ketoacidosis is similar to the ketoacidosis that occurs in diabetes except that, unlike in diabetic ketoacidosis Diabetic Ketoacidosis Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus. Hyperglycemia is the typical finding at presentation with DKA, but patients can present with a range of plasma glucose values. The anion-gap is elevated, as mentioned above because ketones are unmeasured anions. Leukocytosis may indicate an infectious pathology as the trigger and cultures are sent from blood, urine, or other samples as clinically indicated.

Acute Ethanol Intoxication: Αn Overlooked Cause of High Anion Gap … – Cureus

Acute Ethanol Intoxication: Αn Overlooked Cause of High Anion Gap ….

Posted: Sat, 08 Apr 2023 07:00:00 GMT [source]

This goal can usually be achieved through the administration of dextrose and saline solutions (see Treatment). Calcium oxalate crystals in the urine also suggests ethylene glycol poisoning. For example, there have been numerous reports of non-diabetic mothers developing ketoacidosis while breastfeeding on a low-carb diet (13, 14). Although very rare, there have been a small number of cases where a non-diabetic has developed ketoacidosis on very low carb diets.

How Do Ketogenic Diets and Ketosis Work?

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  • Each of these situations increases the amount of acid in the system.
  • The long-term prognosis for the patient is influenced more strongly by recovery from alcoholism.

Patients with mild hyperglycemia may have underlying diabetes mellitus Diabetes Mellitus (DM) Diabetes mellitus is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia… Read more , which may be recognized by elevated levels of glycosylated hemoglobin (HbA1C).

The diabetic nurse should follow all outpatients to ensure medication compliance, followup with clinicians, and adopting a positive lifestyle. Further, the nurse should teach the patient how to monitor home blood glucose and the importance of careful monitoring of blood sugars during infection, stress, or trauma. The physical therapist should be involved in educating the patient on exercise and the importance of maintaining healthy body weight. For patient education information, see the Mental Health and Behavior Center, as well as Alcoholism and Alcohol Intoxication.


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