Question

Diabetic Ketoacidosis (DKA)

History of Present Problem:

Diana Humphries is a 45-year-old woman with chronic kidney disease stage III and diabetes mellitus type1 who checks her blood sugar daily, or whenever she feels like it. She has been feeling increasingly nauseated the past 12 hours. She has had a harsh, productive cough of yellow sputum the past three days. She checked her blood glucose before going to bed last night and it was 382, but then she fell asleep early and missed her bedtime dose of glargine (Lantus) insulin. When she awoke this morning, she had generalized abdominal pain and continued to feel nauseated and had a large emesis. Her glucometer was unable to read her blood glucose because it was too high. She took 10 units of lispro (Humalog) insulin this morning. Her nausea has increased all morning and she has been unable to eat or keep anything down despite having an increased thirst and appetite. She also has had increased frequency of urination. When her lunchtime glucometer gave no reading because it was too high and out of range, she called 9-1-1 to be evaluated in the emergency department (ED).

Personal/Social History:

Diana has been inconsistently compliant with her medical/diabetic regimen due to her struggles with anxiety and depression that have worsened since her mother died three months ago. She considers 200 a good blood sugar reading. She is divorced with no children and has been homeless and has lived in a shelter off and on the past month. She is on Social Security disability because of complications related to diabetes. At one point during the intake interview, she

expressed to the nurse, “I’m going to die anyway, why does all this matter?”

What data from the histories are RELEVANT and have clinical significance to the nurse?

Answer 1

Relevant history and their clinical significance to nurse are

1) Yellow colour sputum indicates that, infection is present in body.

2) Blood sugar levels 382 gm/dL indicates high blood sugar levels which is life threatening.

3) Nausea indicates, there may be an increase in toxins in the body.

4) Anxiety and depression, this can further make physical health more worst.

5) Missing dialysis at time, this may lead to renal failure and also may lead to death.

6) Hopelessness, this may decrease rate of recovery of the patient.

I hope by the above information u got u r answer.

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