Using the case study below, prepare a 3-5 page paper.
A 21-year old female (A.M) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, note that her skin in warm and flushed and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.
You get more information from A.M. and learn
Current labs and vital signs:
The practitioner at the urgent care facility makes the decision that A.M. needs to go to the hospital by ambulance. Once at the Emergency Department (ED), the ED physician orders these items:
The orders above -- which are questionable related to her condition and which are appropriate?
Instructions:
formulate what may be happening with A.M. and how you would improve her condition.
I need 3 pages please don't just answer the questions it's a paper . 3 pages no less please , if you can't do it please don't do it . like I said don't just answer the questions one by one but just add them all together it is a research paper nothing is missing
The pathophysiology of the condition which the patient experience it s termed to be Diabetic ketoacidosis. In this condition the blood sugar levels are very high due to imbalance in its absorption and usage by the cells due to lack of insulin function. This simultaneously increases the content of potassium in the blood leading to hyperkalemia both leads to symptoms nausea ,vomiting,diarrhea, .This results in loss of electrolytes from the body altering the acid base balance,hypotension. To manage this the heart rate increase.In order to combat this the skin becomes warm to prefer fluid.The increase in ketone leads to increase in breathing pattern and a fruity odor smell.The renal system is impaired leading to decreased urine output and prone for infection resulting g in elevation of body temperature
2.The etiology are
Uncontrolled blood glucose levels
Medication non compliance
Lack of adequate and appropriate diet
The clinical manifestation are
-Nausea
-Vomiting
-Diarrhea
-Fruity odour smell
-Decreased urine output
-Tachycardia
-Tachypnea
-Hypotension
-Fever
The appropriate tests are CBC,blood culture, urine tests to rule
out infect
Ketones to find out ketoacidosis
ABG to rule out oxygen and acid base balance
Serum lactate to assess for shock
The investigation which are questionable are
Stool test and C difficile can be done in case of suspicion direct gastrointestinal infection
The expected treatment are-
-Insulin therapy to reduce blood glucose levels
-Insulin calcium bicarbonate infusion to decrease the -elevated
potassium level
-Intravenous fluid to improve blood volume and urine --output
-Antibiotics to treat infection
-Antipyretics to reduce fever
-Antiemetics to reduce nausea and vomiting
-Antidiarrhoeal to prevent loose stools
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