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    Diabetes Case Study

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    Rhina Futrell
    Diabetic ketoacidosis (DKA) occurs when the body produces excess glucose but cannot use it for energy due to insulin deficiency. This causes the body to break down fats and proteins instead, producing ketones which lead to metabolic acidosis. Clinical manifestations of DKA include nausea, vomiting, dehydration and altered mental status due to dehydration and acidosis. Diagnosis is based on high blood glucose, low pH and bicarbonate levels, and ketones in urine or blood. Treatment focuses on insulin, IV fluids, electrolyte replacement, and monitoring for complications.

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    Diabetes Case Study

    Uploaded by

    Rhina Futrell
    29 views2 pages
    Diabetic ketoacidosis (DKA) occurs when the body produces excess glucose but cannot use it for energy due to insulin deficiency. This causes the body to break down fats and proteins instead, producing ketones which lead to metabolic acidosis. Clinical manifestations of DKA include nausea, vomiting, dehydration and altered mental status due to dehydration and acidosis. Diagnosis is based on high blood glucose, low pH and bicarbonate levels, and ketones in urine or blood. Treatment focuses on insulin, IV fluids, electrolyte replacement, and monitoring for complications.

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    Diabetic ketoacidosis (DKA) occurs when the body produces excess glucose but cannot use it for energy due to insulin deficiency. This causes the body to break down fats and proteins instead, producing ketones which lead to metabolic acidosis. Clinical manifestations of DKA include nausea, vomiting, dehydration and altered mental status due to dehydration and acidosis. Diagnosis is based on high blood glucose, low pH and bicarbonate levels, and ketones in urine or blood. Treatment focuses on insulin, IV fluids, electrolyte replacement, and monitoring for complications.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    29 views2 pages

    Diabetes Case Study

    Uploaded by

    Rhina Futrell
    Diabetic ketoacidosis (DKA) occurs when the body produces excess glucose but cannot use it for energy due to insulin deficiency. This causes the body to break down fats and proteins instead, producing ketones which lead to metabolic acidosis. Clinical manifestations of DKA include nausea, vomiting, dehydration and altered mental status due to dehydration and acidosis. Diagnosis is based on high blood glucose, low pH and bicarbonate levels, and ketones in urine or blood. Treatment focuses on insulin, IV fluids, electrolyte replacement, and monitoring for complications.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Objectives

     Describe the pathophysiology related to diabetic ketoacidosis (DKA).

    DKA is an acute complications of Diabetes type 1. DKA happens when the body is
    placed in a state of stress needing more energy than usual. The body starts producing
    glucose in excess but because the deficiency of insulin the body is not able to utilize it as
    an energy source, causing the body to breakdown lipids (lipolysis) and amino acids
    (proteolysis) to be converted into glucose (Glucogenesis) and ketones (Ketogenesis) and
    use them as a source of energy. The excess of glucose in the bloodstream
    (Hyperglycemia) goes into the bladder because the kidneys are not able to reabsorb such
    amount of glucose, then, the kidneys spill the glucose into the urine (Glucosuria). Since
    the glucose is an osmotic solute, it absorbs the water that is in the bloodstream and then
    expelled out the body within the urine, causing extreme dehydration (Osmotic Diuresis).

     Discuss the etiology underlying clinical manifestations for DKA.

    The clinical manifestation of DKA are nauseas, vomiting, abdominal pain, severe
    dehydration, altered mental status, Kussmaul respirations.
    The nausea, vomiting and abdominal pain happens because inflammatory cytokines
    that are release from the process of Lipolysis, irritates the GI tract causing these
    symptoms.
    Even when vomiting can cause an important lost of fluid, the severe dehydration that is
    present in DKA comes mainly from the osmotic diuresis.
    The altered mental status is caused by dehydration and the metabolic acidosis caused by
    the excess of ketones in the body. This excess of ketones also causes abnormal heart
    rate and Acetone breath.

     Evaluate results of diagnostic testing in a patient with DKA.

    - Blood glucose level ≥ 250 mg/dL


    - Arterial blood pH < 7.30
    - Serum bicarbonate level < 16 mEq/L
    - Moderate to large ketones present in urine or serum.

     Identify relevant assessment data for a patient with DKA.


    - Physical assessment
    - Vital Signs
    - Mental status assessment
    - Blood work (CBC, Blood glucose, Ph, Electrolytes, BUN, Ketones, ABG)
    - Urinalysis
     Prioritize nursing care of a patient with DKA.

    - Monitor vital signs


    - Check Blood sugar levels and administer Insulin
    - Administering IV fluids
    - Monitoring glucose and ketones in urine
    - Monitoring ECG
    - Electrolyte replacement

     Appropriately delegate nursing care of a patient with DKA.


    Nurses can delegate to UAP Obtaining blood glucose readings using the glucose monitor and
    vital signs.
     Describe the interprofessional care of a patient with DKA.
    Hospitalization of patient depends on how severe the symptoms are. If electrolyte imbalance is
    not severe, DKA can be treated as outpatient basis. If other symptoms are present patient must be
    hospitalized.

     Develop an individualized teaching plan for a patient with DKA.

    1. Accurately administer insulin in relation to meals as prescribed.


    2. Check your glucose sugar at least 4 times a day
    3. Drink extra fluids to prevent dehydration
    4. Monitor heart rate

    Case Study
    J.D.’s results of the Basal Metabolic panel are within the normal range. The glucose level is
    significantly elevated, which indicates Hyperglycemia. The pH level of 7.03 is low, which
    indicates metabolic acidosis, the PaCO2 level of 17 mm Hg is low which means that the body is
    trying to reverse metabolic acidosis exhaling excess of CO2. The HCO3 level of 11.6 mEq/L is
    low because of buffering excess H+ ions in blood and PaO2 level of 81 mm Hg is within normal
    range. As the nurse of J.D I would prioritize IV access for correction of hyperglycemia with
    intravenous insulin, for fluids replacement when the patient needs it and frequent monitoring.

    Refences:
    Harding, M., Roberts, D., Reinisch, C., Hagler, D., Kwong, J. (102019). Lewis's Medical-
    Surgical Nursing, 11th Edition. [[VitalSource Bookshelf version]]. Retrieved from
    vbk://9780323551496

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