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All Journal JURNAL PENDIDIKAN TAMBUSAI Journal of Humanities and Social Studies Journal of Telenursing (JOTING) ELEMENTARY : Jurnal Inovasi Pendidikan Dasar Jurnal Ilmiah Pendidikan Dasar (JIPDAS) Jurnal Pendidikan Dasar JGK (Jurnal Guru Kita) Innovative: Journal Of Social Science Research JURNAL HANDAYANI PGSD FIP UNIMED Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) Malahayati International Journal of Nursing and Health Science
Winara, Winara
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Arts Humanities Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Nursing Public Health Social Sciences Other

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Refractory hyperglycemia in a geriatric patient with diabetic ketoacidosis: A critical care nursing case report Pranata, Yodha; Winara, Winara; Rizkianti, Intan; Maryam, Nina; Prawesti, Ayu
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 7 (2025): Volume 8 Number 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i7.1005

Abstract

Background: Refractory hyperglycemia in diabetic ketoacidosis (DKA) presents a critical challenge in geriatric patients due to multifactorial physiological and clinical complexities. Early recognition and integrated management are essential, with critical care nursing as a pivotal component. Purpose: This case report aims to describe and analyze the multifactorial causes of refractory hyperglycemia in a geriatric DKA patient, highlighting the importance of early detection, comprehensive correction, and collaborative nursing roles. Method: A descriptive analytic approach was employed to examine the clinical course of a 75-year-old woman with DKA and persistent hyperglycemia. Data were collected from direct patient observation, systematic physical examinations, laboratory assessments, imaging, and multidisciplinary clinical records. Daily therapeutic interventions and patient responses were meticulously documented. Results: Persistent hyperglycemia resulted from several interacting factors: the impact of glucocorticoids on glycemic control, effects of severe pulmonary infection on insulin resistance, the role of electrolyte disturbances in exacerbating hyperglycemia, the relationship between heart failure and diuretic use, the impact of malnutrition and sarcopenia on insulin resistance, and the need for an integrated therapeutic approach. Each factor contributed to increased insulin resistance and complicated glycemic control. Conclusion: Optimal management of refractory hyperglycemia in elderly DKA patients requires early identification and simultaneous correction of underlying factors, supported by intensive critical care nursing and multidisciplinary collaboration.
Co-Authors , Waliyul Maulana Siregar Afriadi, Putra Ambarita, Dody Feliks Pandimun Andri Kristianto Sitanggang Angginta, Teguh Angin, Laurensia Masri Perangin Apiek Gandamana Ayu Prawesti Priambodo Batubara, Hamdan Yusup Bungana, Reh Charles Fransiscus Ambarita Daulat Saragi ELVI MAILANI Fitriyani, Afifah Hanniyah, Ummu Harahap, Nisa Pratiwi Hasibuan, Hikmah Khairani Hatmi, Edizal Kuswara, Sani Widianti LALA JELITA ANANDA LAURENSIA MASRI PERANGINANGIN Limbong, Febby ontryna Manurung, Imelda Free Unita Maryam, Nina Muhaemin Muhaemin Nasution, Nia Afrilda Nasution, Yusra Pane, Dian Ade Putri Pranata, Yodha Prawijaya, Septian Rahman, Anisa Ramadani, Alya Ratno, Suyit RISMA SITOHANG Risnianingsih, Nina Rizkianti, Intan ROBENHART TAMBA Rycco Darmareja Sakinah, Auliya Saparingga Dasti Putri Shabina Dinisyah Fajar, Natasya SIDIK SIREGAR, FAJAR Simanihuruk, Lidia Simanungkalit, Selsa Sinaga, Septi Rahmadani Siregar, Arifin Sri Mustika Aulia Sri Yunita Surbakti, Jean Emeninta Susanti, Vera SYAHRIAL SYAHRIAL Syakila, Qaulan Tambunan, Husna Parluhutan Tambunan, Natalia Try Wahyu Purnomo Usman, Khairul Wildansyah lubis, Wildansyah Yanny Trisyani Zahara, Jihan Zega, Darling Krisman