Question

7:25 Done NR283-Case Study 4-Endocri... 17 Physical Exam/Findings: (Your findings) General: thin female, falling asleep while talking Weight-122lbs Height-34 Vital Signs: T-100.1, Pulse-132, RR-27, BP-92/50, O2 Sat-95% on room air, Pain-6/10 Skin: no rashes, skin warm/dry, hair-unremarkable, nails- unremarkable, golf ball-sized fluid filled furuncle noted to left groin with red streaking down thigh Neurological: lethargic, oriented x2. speech slurred, facial movements symmetric, pupils equal and reactive, gait not assessed Head and neck: symmetrical, full rom of neck, no neck swelling Eyes: conjunctiva clear and free of erythema or exudate, pupils round, regular, equal and reactive, sclera is white Throat/mouth: dry OS membranes, mucous membranes pink, mucous membranes intact Cardiovascular: lachycardia, no edema, no JVD Pulmonary: deep & rapid breathing pattern, lungs clear, equal expansion, fruity order to breath Abdomen: no distention, bowel sounds active x4, no guarding Abnormal Laboratory Data: WBC-high Hemoglobin-normal Hematocrit-normal Platelets-normal Glucose-450 Anion gap-30 Sodium-130 Potassium-5.5 Urinalysis-+ glucose, + ketones Arterial blood gas-pH-7.25, PC02-28, HCO3-15 5) Based on the patient's presenting manifestations, what is the diagnosis? 6) What manifestations did you use to diagnose the patient? 7) Which diagnostic or laboratory test results above did you use to diagnose the patient? 8) What specifically noted in the assessment caused the disorder? The patient was transferred to the intensive care unit and has an order to transfer to the floor. You walk in the room at 0900 to check on her. She appears to be asleep & has not touched her breakfast tray. Your S e rt 0815 when she

Answer 1

5.The patient is showing Partially Compensated Metabolic Acidosis in relation to the ABG report .It shows a typical signs and symptoms associated to Diabetic ketoacidosis

6.The manifestation which lead to diagnose are

• Increased glucose levels
• Increased anion gap
• Decreased sodium level
• Glucose and ketone in urine
• Fruity odour to breath
• Lethargy
• Decreased pH

7.The diagnostic test used to diagnose are

• Urinanalysis
• ABG
• Blood glucose
• Anion gap test

8.The extreme high levels of glucose in the blood has altered the insulin mechanism resulting in alteration of the serum electrolyte levels of the blood with altering the acid base balance of the body.In simple the very high blood glucose levels caused the disorder

9.This assessment suggests that the patient is in hypoglycemic state

10.Before administration of insulin the should have mage sure that the blood sugar levels are monitored and insulin is administered only as per need hardly 5 to 10 minutes before meals.