Final answer:
Urine output is not a good marker of resuscitation in patients with DKA because the osmotic diuresis caused by high blood glucose levels can lead to frequent urination that does not reflect actual hydration status. Additionally, impaired kidney function in concentrating urine makes it an unreliable measure. Treatment focuses on rehydration, electrolyte replacement, and insulin administration.
Step-by-step explanation:
The student asked why urine output is not a good marker of resuscitation in patients with diabetic ketoacidosis (DKA). In DKA, the kidneys attempt to excrete excess glucose from the bloodstream, which can lead to an osmotic diuresis. This diuresis causes frequent urination and contributes to dehydration, despite the fact that the body is already depleted of fluids. As DKA progresses, the dehydration that occurs cannot be accurately assessed by urine output alone because urine output may remain high due to the body's attempt to get rid of excess glucose and ketone bodies. Moreover, the kidneys' ability to concentrate urine in response to fluid resuscitation is impaired, making urine output an unreliable marker for effective resuscitation in DKA.
Additionally, other factors such as medications, fluid and electrolyte balances, and individual variations in renal threshold for glucose can influence urine output, further complicating its use as a resuscitation marker in DKA. Proper treatment for DKA involves rehydrating with intravenous fluids, gradually replenishing electrolytes, and administering insulin to correct the underlying metabolic abnormalities.