Need help? We are here

Weeks of polydipsia, polyuria and a fever.

Case Study 7: Diabetic Ketoacidosis
Carly is a 12-year-old girl who presents to the emergency department after two weeks of polydipsia,
polyuria and a fever.
In the last 24 hours, Carly has complained of abdominal pain and nausea, and has been vomiting.
Over the last 2-3 months she has experienced a 4 kg weight loss.
In ED, she appears quite unwell. She is tachypnoeic with deep sighing respirations and ‘acetone’
smelling breath.
She has orthostatic hypotension and she is tachycardic. Her skin is pale, dry and hot to touch.
An arterial blood gas analysis shows a pH of 7.06 and PaCO2 of 10 mmHg which demonstrates the
severity of her acidosis. Her urinalysis is positive for glucose and ketones.
Blood tests show her serum glucose to be 48 mmol/L with an elevated β-hydroxybutyrate (β-HBO)
level of 1.9 mmol/L.
Her serum Na+ has been measured at 128 mmol/L and serum K+ at 6.3 mmol/L.
CRP is elevated as is her WCC which also shows immature band cells.
Carly is drowsy, easily roused but also somewhat irritable. At best her GCS is E3+V4+M5 = 12
She is quickly commenced on IV fluids and an IV insulin infusion with gradual clinical and biochemical
improvement over the next 3-4 hours. Six (6) hours into her resuscitation and treatment, there is a
noticeable neurological deterioration where she becomes highly agitated, and inappropriate.
Subsequently she has self-terminating tonic-clonic seizure and following which she is unarousable.
Her GCS on assessment is 6 and her pupils are dilated but reactive. She is intubated and
administered Mannitol. Over the following 24 hours her GCS gradually improves to the point that
she is extubated, and discharged home a week later with no neurological deficits.
Assignment Task:
1. Develop a concept map which identifies and links the presentation and pathophysiological
processes that have occurred in Carly, over the time leading up to Carly’s presentation to
hospital
2. Explain how these pathophysiological disease processes lead to the observed signs, symptoms
and test results found in this patient after admission to hospital and her subsequent
deterioration.

Share This Post

Email
WhatsApp
Facebook
Twitter
LinkedIn
Pinterest
Reddit

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

Respond to your classmates and explain if their analysis would be applicable to one of the other PACs described in

Respond to your classmates and explain if their analysis would be applicable to one of the other PACs described in the chapter.The Four PACS (Post-Acute Care)1.Skilled nursing facilities (SNFs)2.Long-term care hospitals (LTCHs)3.Inpatient rehabilitation facilities (IRFs)4.Home health agencies (HHAs) (MedPAC 2017a, xvi)Post #1Post-acute care facilities are meant to provide various rehabilitation

Review the code of ethics of theInstitute of Electrical and Electronics Engineer IEEEandNational Society of Professional Engineers NSPE.Compare the two

Review the code of ethics of theInstitute of Electrical and Electronics Engineer (IEEE)andNational Society of Professional Engineers (NSPE).Compare the two and answer the following questions: (write at least 3 paragraphs)How is the language used in each different?What are the similarities between the two codes of ethics?Find a professional organization ofyour

Review both resources provided below and reflect on 2 key differences between the UK and US Health systems. What are

Review both resources provided below and reflect on 2 key differences between the UK and US Health systems. What are key opportunities related to advocacy and politics interventions that can be done by advanced practice nurses to improve our current health system?https://www.youtube.com/watch?v=R4Y0TKiwNgohttps://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-post-op-clots-better-u-s-comparable-countriesSummary of the American Health Care Act.pdf

Review the FBI National Gang Report at the following website https:www.fbi.govfilerepositorynationalgangreport2015.pdfview. Then visit the FBIs Youtube channel at https:www.youtube.comuserfbi and

Review the FBI National Gang Report at the following website https://www.fbi.gov/file-repository/national-gang-report-2015.pdf/view. Then visit the FBI’s Youtube channel at https://www.youtube.com/user/fbi and the FBI’s “What we Investigate: Gangs” site at https://www.fbi.gov/investigate/violent-crime/gangs. Use the information shared on the FBI website to analyze the following questions:How many gangs are there in the United States?Which