Diabetic Ketoacidosis (DKA) is a complication of diabetes mellitus. Blood glucose instability is one of the primary nursing diagnoses in patients with Diabetic Ketoacidosis (DKA). Optimal nursing management of blood glucose fluctuations through both independent and collaborative nursing interventions is essential to anticipate the risk of persistent hyperglycemia. This case study aims to examine the implementation of nursing care for patients with DKA.
Nursing care for a patient with Diabetic Ketoacidosis experiencing blood glucose instability was carried out in the Emergency Unit and the Seruni Inpatient Ward of Dr. Harjono General Hospital Ponorogo over a four-day period, from June 10 to 13, 2025. The approach used in delivering this care followed the steps of the nursing process.
The initial assessment revealed that the patient experienced a decreased level of consciousness. Objectively, the patient appeared lethargic, with a weakened general condition, a GCS score of 6 (sopor), and supported by laboratory results indicating hyperglycemia at 555 mg/dL and positive ketone levels at 3. Nursing interventions included regular monitoring of blood glucose levels and providing education to the patient’s family regarding diabetes mellitus management. Evaluation of these interventions showed significant clinical improvement, marked by stabilized blood glucose levels, increased alertness, reduced drowsiness, and a decrease in complaints of fatigue and weakness.
The implementation of nursing care for patients with Diabetic Ketoacidosis experiencing blood glucose instability is expected to contribute as a reference for nursing practice, particularly in the management of patients with DKA and hyperglycemia.

Keywords : Diabetic Ketoacidosis, Glucose level instability