Ketone Kyle — Diabetic Ketoacidosis
Type 1, glucose > 250, ketones, acidosis — fluids first
Kyle gets the flu and stops eating, so he skips his insulin too. Without insulin his cells starve in a sea of sugar, and his body starts burning fat for fuel — leaving acid behind.
Kyle's type 1 diabetes tips into DKA during illness. Polyuria, polydipsia, vomiting, Kussmaul breathing and ketones. Isotonic fluids first, then an insulin infusion with potassium monitoring, and add dextrose once glucose falls to about 250 to avoid hypoglycemia.
Read Ketone Kyle's full story →The story arc
The setup
Influenza, poor intake, and the assumption that no food means no insulin needed.
The turn
He urinates constantly, cannot stop drinking, then starts vomiting and cramping.
The crisis
Glucose 480, pH 7.09, bicarbonate 10, ketones large, and he is breathing deeply with fruity breath.
The save
0.9% saline runs first, an insulin infusion follows with hourly glucose and potassium checks, and D5 is added when glucose reaches 250.
NCLEX study section — Diabetic Ketoacidosis
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Endocrine & Metabolic
Take this chapter into practice questions on the same topic.