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NU424 Diabetic Ketoacidosis Case Study 3;DKA case study with complete solution

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NU424 Diabetic Ketoacidosis Case Study 3;DKA case study with complete solution

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NU424 Diabetic Ketoacidosis
Case Study 3;DKA case study with complete solution

, NU424 Diabetic Ketoacidosis
Case Study # 3

Case Presentation:
You are working in an outpatient clinic when a mother brings in her 20-year-old
daughter, C.J., who has type 1 diabetes mellitus (DM) and has just returned from a
trip to Mexico. She has had a 3-day fever and diarrhea with nausea and vomiting.
She has been unable to eat and has tolerated only sips of fluid. Because she was
unable to eat, she did not take her insulin as directed. You note C.J. is unsteady, so
you take her to the examining room in a wheelchair. While assisting her onto the
examination table, you note her skin is warm and flushed. Her respirations are
deep and rapid, and her breath is fruity and sweet smelling. C.J. is drowsy and




m
unable to answer your questions. Her mother states, "She keeps telling me she's so




er as
thirsty, but she can't keep anything down."




co
eH w
o.
rs e
1. List four pieces of additional information you need to elicit from C.J.'s
ou urc
mother.
How long ago was she diagnosed with diabetes? How did this start? What
o

was her fever? Has she been peeing? What did she eat and drink in Mexico?
What is her glucose level? What has she been drinking?
aC s
vi y re



Case Study Progress
Case Progression:
ed d




The mother tells you the following:
ar stu




“Blood glucose monitor has been reading ‘high.’"
“C.J. has had sips of ginger ale, but that’s all.”
is




“She has been vomiting about every other time she drinks.”
Th




“When she first got home, she went [voided] a lot, but yesterday she hardly went
at all, and I don't think she has gone today.”
sh




“She went to bed early last night, and I could hardly wake her up this morning.
That's why I brought her in.”




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