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 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