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Question: 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

17 Oct 2022,9:57 PM

 

Essentials of Pathophysiology: Diabetes Case Study

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, her skin is 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 the following:

She had some readings on her glucometer which were reading ‘high’
She vomits almost every time she takes in fluid
She hasn’t voided for a day but voided a great deal the day before
She’s been sleeping long hours and finally woke up this morning and decided to seek care
Current labs and vital signs:

What is the disorder and its pathophysiology that you expect the health care provider to diagnose and treat?
Describe the etiology of the disorder A.M is experiencing.
Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
Identify and describe the expected treatment options for A.M. based on the disorder and clinical manifestations.

Instructions:

Summarize the questions above and formulate what may be happening with A.M. and how you would improve her condition.

Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.

You can find useful reference materials for this assignment in the School of Nursing guide: https://guides.rasmussen.edu/nursing/referenceebooks

Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa

Case study adapted from:

Harding, M.M. & Snyder, J.S. (2015). Winningham’s critical thinking cases in nursing: Medical-surgical, pediatric, maternity, and psychiatric. Retrieved from: https://ebookcentral.proquest.com/lib/ras/detail.action?docID=2072336.

 

Expert answer

 

A.M. is suffering from diabetic ketoacidosis (DKA).

This disease is caused by a build-up of ketones in the blood, which can lead to a number of serious health complications.

In other words, it results from very high glucose levels in the blood (hyperglycemia). In response to this, the body begins to produce ketones, which are a by-product of fat metabolism.

 

The most common symptoms of DKA include:

 

–Excessive thirst

 

–Frequent urination

 

–Fatigue

 

–Nausea and vomiting

 

–Abdominal pain

 

–Confusion or difficulty thinking clearly

 

NOTE: Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus. DKA occurs when the body cannot use glucose for energy because there is not enough insulin, so the body begins to break down fat stores instead. This process produces ketones, which can build up and cause a number of dangerous symptoms, including high blood sugar, excessive thirst and urination, nausea and vomiting, shortness of breath, confusion, and coma. Treatment for DKA includes insulin therapy to bring blood sugar levels under control and fluids to correct dehydration. With prompt and proper treatment, most patients with DKA recover fully. Diabetic ketoacidosis is a serious complication of diabetes mellitus that can be life-threatening if not treated promptly and properly. Early diagnosis and treatment are essential for the best possible outcome.

 

 

 

If left untreated, DKA can lead to coma or even death. Treatment for this condition typically includes insulin therapy and close monitoring by a medical team. With proper treatment, most patients with DKA make a full recovery.

 

She has been started on insulin therapy and is being monitored closely. She will continue to require close monitoring and treatment until her condition improves.

 

The patient's blood sugar levels are being monitored closely and she is receiving insulin therapy to help stabilize her blood sugar levels. Her condition is being closely monitored and she will continue to require treatment until her condition improves.

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