In severe DKA, patient breathing becomes rapid, labored and deep. This breathing pattern is termed Kussmaul respirations.
Dehydration occurs rapidly and is very serious with DKA. As the blood osmolarity increases due to high blood sugar (from lack of insulin), water is drawn into the GU system. Thus, patients become severely dehydrated but are producing excess urine.
Patients with excess ketone bodies and hyperglycemic crisis (as in DKA) experience abdominal pain. This is more pronounced in children, and may mimic the symptoms of an acute abdomen.
Accumulation of ketones and a hyperosmolar state manifests in nausea and vomiting in patients. The mechanism with patients experiencing these symptoms has to do with levels of salts such as sodium and potassium decreasing in the body, which triggers nausea and vomiting.
Patients with severe DKA suffer from mental status changes and delirium, which often manifest as psychosis. The etiology for these symptoms is the electrolyte and fluid balance changes incurred on the patient.
Patients with DKA often have fruity breath odor. This is because one type of ketone which accumulates, acetone, has a fruity smell.
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