Diabetes Case Study

Instructions

Using the case study below, prepare a 3-5 page paper.A 21-year old female (A.M) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since shes been ill and unable to keep any food down. Shes only tolerated sips of water and juices. Since shes also been unable to eat, she hasnt taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that shes unsteady, note that her skin in warm and flushed and that shes drowsy. You also note that shes breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.You get more information from A.M. and learnShe had some readings on her glucometer which were reading highShe vomits almost every time she takes in fluidShe hasnt voided for a day but voided a great deal the day beforeShes been sleeping long hours and finally woke up this morning and decided to seek careCurrent labs and vital signs:What is the pathophysiology for the condition you believe A.M. has?Relate the etiology and clinical manifestations for the condition you identified for A.M.The practitioner at the urgent care facility makes the decision that A.M. needs to go to the hospital by ambulance. Once at the Emergency Department (ED), the ED physician orders these items:1000 ml Lactated Ringers (LR) IV stat36 units NPH (Humulin N) and 20 units regular (Humulin R) insulin SQ nowCBC with differential; CMP: blood cultures X2 sites; clean-catch urine for UA and C&S; stool for ova and parasites; Clostridium difficile toxin, and C&S; serum lactate; ketone; osmolality; ABGs on room air1800 calorie, carbohydrate controlled dietBed restAcetaminophen (Tylenol) 650 mg orally Q4 hrs PRNFurosemide (Lasix) 60 mg IV push nowUrinary output every hourVS every shiftThe orders above -- which are questionable related to her condition and which are appropriate?What are the expected treatments for this condition?Instructions:Summarize the questions above and formulate what may be happening with A.M. and how you would improve her condition.Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.You can find useful reference materials for this assignment in the School of Nursing guide: https://guides.rasmussen.edu/nursing/referenceebooksHave questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apaCase study adapted from:Harding, M.M. & Snyder, J.S. (2015). Winninghams critical thinking cases in nursing: Medical-surgical, pediatric, maternity, and psychiatric. Retrieved from: https://ebookcentral.proquest.com/lib/ras/detail.action?docID=2072336.

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