Nursing interventions for Diabetic Ketoacidosis (DKA) in children include:

- Assessing the patient: Check blood sugars, mental status, signs of infection, and urine output
- Stabilizing the patient: After initial stabilization of circulation, airway, and breathing, specific treatment of DKA requires correction of hyperglycemia with intravenous insulin, frequent monitoring, and replacement of electrolytes, mainly potassium, correction of hypovolemia with intravenous fluids, and correction of acidosis
- Administering insulin: IV insulin is the standard treatment for DKA as the patient needs insulin rapidly to decrease glucose
- Starting two large-bore IVs: This is necessary for fluid resuscitation and maintenance, insulin therapy, electrolyte replacement, and supportive care, which are the mainstays of management in DKA
- Administering fluids: Provide intravenous fluid replacement to restore peripheral circulation, renal perfusion, and electrolyte balance
- Monitoring fluid and electrolyte balance: Check electrolytes as potassium levels will drop with insulin treatment, and monitor for hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and hypophosphatemia
- Educating the patient and family: Teach the patient on the importance of compliance with diabetic medications, the importance of follow-up, and how to recognize symptoms of DKA as well as prevent recurrences
- Coordinating with a diabetes educator: Patients who struggle with managing their diabetes may need education by a diabetes educator
- Monitoring for cerebral edema: Cerebral edema occurs in ~0.5% of children presenting in DKA, and it has a mortality of ~25%. At highest risk are (1) children newly diagnosed with diabetes, (2) younger children, and (3) children with the greatest degree of dehydration and acidosis
- Preventing falls and injuries: Patients with DKA may experience weakness and fatigue, often exacerbated by dehydration and electrolyte imbalances. To prevent falls and injuries, nurses should provide assistance with ambulation when necessary and ensure a safe environment