Diabetic ketoacidosis Case scenario

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Diabetic ketoacidosis Case scenario

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 DiagnosisDiabetic 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

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