Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days ORDER NOW FOR ORIGINAL PAPER
NR 507 Week 5: Discussion Part One
Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show:
| Sodium (Na+) | 156 mEq/L |
| Potassium (K+) | 4.0 mEq/L |
| Chloride (Cl–) | 115 mEq/L |
| Arterial blood gases (ABGs) | pH- 7.30; Pco2-40; Po2-70; HCO3-20 |
| Normal values | |
| Sodium (Na+) | 136-146 mEq/L |
| Potassium (K+) | 3.5-5.1 mEq/L |
| Chloride (Cl–) | 98-106 mEq/L |
| Arterial blood gases (ABGs) | pH- 7.35-7.45
Pco2- 35-45 mmHg Po2-80-100 mmHg HCO3–22-28 mEq/L |
Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days
ORDER NOW FOR ORIGINAL PAPER
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What is the etiology of Diabetic Ketoacidosis?
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Describe the pathophysiological process of Diabetic Ketoacidosis.
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Identify the hallmark symptoms of Diabetic Ketoacidosis.
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Identify any abnormal lab results provided in the case and explain why these would be abnormal given the patient’s condition.
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What teaching would you provide this patient to avoid Diabetic Ketoacidosis symptoms?
In addition to the textbook, utilize at least one peer-reviewed, evidence based resource to develop your post.
Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days
- abnormal given the patient’s condition.
Sodium (Na+) 156 mEq/L elevated normal range 136-146 mEq/L. The American Diabetes Association criteria for the diagnosis of DKA are: (1) a serum glucose level >250 mg/dl, (2) a serum bicarbonate level <18 mg/dl, (3) a serum pH <7.30, (4) the presence of an anion gap, and (5) the presence of urine and serum ketones. Arterial blood gases (ABGs) Pco2-40; Po2-70; HCO3-20. Metabolic acidosis confirmed by arterial blood gas (ABG) analysis is one of the diagnostic criteria for diabetic ketoacidosis (DKA). Given the direct relationship between end-tidal carbon dioxide (ETCO2), arterial carbon dioxide (PaCO2), and metabolic acidosis, measuring ETCO2 may serve as a surrogate for ABG in the assessment of possible DKA. (Soeimanpour et al., 2013). These labs are abnormal because the body is compensating for the high level of glucose in the renal system and the loss of glucose in the urine. Ms. Blake has not been eating and probably has been taken her insulin as she was before she got sick. When you have diabetes and don’t get enough insulin and get dehydrated, your body burns fat instead of carbs as fuel, and that makes Ketones. Lots of ketones in your blood turn it acidic. People who drink much alcohol for a long time and don’t eat also enough build up ketones. It can happen when you aren’t eating at all, too. This condition can all lead to or be a predictor of existing Ketoacidosis.
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