Diabetic Ketoacidosis Pathway - Children's Hospital Central California

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1.0 .1 cc U IU µg MS TIW QD QID QOD MSO 4 MGSO 4DRUG SENSITIVITY: WT: kgORDERS: GENERIC EQUIVELANT WILL BE DISPENSED UNLESS ORDER SPECIFIES “DO NOT SUBSTITUTE” If Then, Glu 60-80: Give 4 oz (120 ml) of juice orally and retest blood sugar in 15 minutes. Repeatuntil blood sugar is greater than 100 mg/dl. If necessary to repeat more than twice, page physician oncall. If Then, Glu < 60: If blood sugar is less than or equal to 60 mg/dl, give 8 oz (240 ml) of juice orallyand recheck blood sugar in 15 minutes. If blood sugar still less than 60 mg/dl, page MD on call. Ifblood sugar is 60-80 mg/dl, follow instructions above. Notify MD if, Glucose: Page physician with pre-meal blood sugar for insulin orders, unless ordershave already been written to cover that dose. Insulin orders should be reviewed and revised at leastonce every 24 hours. RN Communication, DC Plan: Plan on patient being discharged one day after teaching started by diabeticnurse educator. The diabetic nurse educator will start education once the patient has been transitionedto subcutaneous insulin (so if transition is at lunch, education should start that afternoon). RN Communication Miscellaneous: Assist patient and their family in keeping a “Diabetes Diary” atpatient’s bedside. Use only after patient is on subcutaneous insulin. RN Communication, Medication: Parent to draw up and administer all subcutaneous insulin injectionswith nursing supervisionPhysician’s Signature/ID number : ______________________________________ Date: ____/____/____ Time: _________DKA page 2 of 2 Patient Label0032*0032*pathway 3/2012Physician’s Order Sheet
Fluidml/hrFluidml/hrFluidml/hrInsulinunit/kg/hrUrineOutputHROutsideFacilityCHCCED07 08 09 10 11 12 13 14 15 16 17 18 TotalRRBPTempBloodGlucose mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dl mg/dlI.D. #NaKClCO 2BUN/CrCaPhospHGlascowComaDKA0621*0621*pathway 3/2012FlowsheetPatient LabelDate: _________________
Page 3 and 4: Diabetic Ketoacidosis Pathway - Adm
Page 5 and 6: Physician’s Signature/ID number :
Page 7 and 8: 1.0 .1 cc U IU µg MS TIW QD QID QO
Page 9: 1.0 .1 cc U IU µg MS TIW QD QID QO
Page 13 and 14: Diabetes DiaryINSULINBLOOD SUGAR TE
Page 15 and 16: Diabetes Education Check-ListMust b
Page 17 and 18: 4. Acidosis variable5. Anion Gap >
Page 19 and 20: is adequate, although there are the
Page 21: Dictation: 1-800-411-1001 (#963)D/S

Diabetic Ketoacidosis Pathway - Children's Hospital Central California

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