ketoacidosis /kē′tōas′idō″sis/ [Gk, keton, form of acetone; L, acidus, sour, osis, condition] , acidosis accompanied by an accumulation of ketones in the body, resulting from extensive breakdown of fats because of faulty carbohydrate metabolism. It occurs primarily as a complication of diabetes mellitus. See also diabetes mellitus, ketosis. −ketoacidotic, adj. ▪ OBSERVATIONS: Ketoacidosis is characterized by a fruity odor of acetone on the breath, mental confusion, dyspnea, nausea, vomiting, dehydration, weight loss, and, if untreated, coma. ▪ INTERVENTIONS: Emergency treatment includes the administration of insulin and IV fluids and the evaluation and correction of electrolyte imbalance. Nasogastric intubation and bladder catheterization may be required if the patient is comatose. ▪ PATIENT CARE CONSIDERATIONS: Before discharge of the patient from the hospital, the nurse carefully reviews the meal plan, activity levels, blood glucose and urine ketone monitoring, and insulin schedule prescribed, emphasizing to the patient that ketoacidosis may be life threatening and is largely avoidable by strict adherence to the patient’s diabetic regimen, monitoring, and appropriate action for illness or stress. A referral to a certified diabetes educator and endocrinologist by the primary health care provider is often warranted.
