Question

Case Study #2 Linda D., a 13-year-old girl who was a known diabetic, became comatosed and was rushed to the hospital by her parents. Two days before admission, she went to school feeling ill and vomited that evening. Linda's vomiting persisted with only a 6-hour pause during sleep. She refused to take her insulin the following morning even after she had been instructed to give herself the regular insulin dose and control her nausea with Tigean (trimethobenzamide HCI). The emergency room (ER) physician noted that she was breathing deeply and rapidly and that her breath had a fruity odor. The laboratory results are shown below. Glucose: Patient: 430 mg/dL Reference Range: 70 - 105 mg/dL BUN: Patient: 43 Reference Range: 8.26 mg/dL Creatinine Patient: 2.6 mg/dL Reference Range: 0.6 - 1.2 mg/dL

Answer 1

I present care are: A / Results in / / / halient's blood glucose as fjal 5 Blood wea metropen is high 43rfall I creatinine = 2 6 offell high) & Soduinte Low (129 mm Li Potfassen bit heph 5.8 mmol/L 66) Chloride Levele low sommol/L f Tofal lag is low q nanol Los 8 Bicarbinefes Level is low lummol/L g) High level of cholestruly trilycerides - log Gleruose & ketone present to 1 Linda's clerical Coradition is not good as her breathing pattern is not hormed a hos fruity odor. Her increased blodd ghecose level is Nesponsible for ferl condition - May be petient has developed Diabetic ket oudosis resulting her de - -

Date: Totent's Co2 Level is low as Recorbonefes all also low The because in Diabetic ketoacidon becarbonate buffer is exhausted te metabolic acidosis is present which is compensated by rémoving ca from the body by hyperitentilation resulting in Low cos Level. 4 Metabolic acidosis fresent in the pakert trigger her abormed breathing as she hyperventilates to compens -ales existing audosis by removing Carbondioxide 0 ruity Breath odor is because of friesence of kelnes in blood of wrine Scanned with . CamScanner