Question

Lara Fielding, a 20-year-old college student, comes to the student health center with a 4-day history of flu-like symptoms. She reports feeling increasing fatigue, thirst, and nausea over the last 24 hours. Further assessment and lab work indicates that Lara is experiencing diabetic ketoacidosis (DKA). She is transferred to an acute care facility for treatment. Lab work reveals that Lara's blood glucose is 370 mg/dl. plasma bicarbonate is 8 mEq/l, potassium is 5.2 mEq/l , and she has elevated ketones in her urine. The goals of treatment in DKA include correcting fluid imbalance and restoring normal pH, electrolytes and glucose.

Identify 3 priority nursing diagnoses from the scenario overview; Identify the 3 top nursing assessments for this patient; Identify the 3 top nursing interventions for this patient; Identify 2 -3 priority orders for this patient.

Answer 1

Ans) Nursing Diagnosis:

- Risk For Fluid Volume Deficit.
- Risk For Infection.
- Deficient Knowledge.
- Imbalanced Nutrition: Less Than Body Requirements.

Nursing Assessment:

- Expect to administer up to 1 or more liters of fluid per hour over the first few hours of treatment. M

- Monitor the patient's vital signs, serum sodium level, breath sounds, and urine output to assess for fluid overload.

- Etiologies of DKA commonly include infection and inadequate insulin therapy.

Nursing Intervention:

- Fluid resuscitation with 0.9% sodium chloride.
Insulin infusion (fixed-rate intravenous insulin infusion) at 0.1 unit/kg/hr.
- Close monitoring of vital signs, blood glucose, ketones, electrolytes and blood gases.
- Continue FRII until DKA has resolved before converting to subcutaneous.