This a Case scenario based assignment.
A woman aged 68, came into the Emergency for Drowsy and Low Blood pressure. She had fever and cough for 2/7, Went to GP and noted high glucose level. Past medical history of DM, HTN, High anion gap metabolic acidosis and previous admission of DKA secondary to Sepsis
Vitals:
temp – 37.7
bp- 104/59
pr- 124
rr- 16
spo2- 96
Hs1s2
lungs clear
abd soft
tongue dry
treatment
Arterial Blood Gas
X-ray
Cardiac Enzymes
Glucose/Ketone
Iv fluids: Normal Saline 0.9% 500mls infused over 1hour
Insulin Actrapid Infusion
IV Augmentin 1.2g
dextrose 5% normal saline 0.9% infusion 500mls over 4hrs
findings
BGM 15mmol/l (high)
ketone 5.1 (high)
ph 7.224 (low)
pco2 25.8 (high)
base excess -15.5 (super low)
bicarbonate 12.6 (low)
urine glucose 4+
urine ketone 3+
urine blood 2+
ecg – sinus tachycardia
*after* treatment
glucose 7.8
ketone 2.6
ph 7.32
Primary Diagnosis: Diabetic ketoacidosis
Essay must include the Pathophysiology of the Diagnosis.
Explanation for the treatment, blood results and progress (how it correlate)
Treatments must be supported with Evidence Based Literatures.
References 6-8 intext citation APA style
2000 words essay
