What is the pathophysiology for the condition you believe A.M. has?2. Relate the etiology and clinical manifestations for the condition you
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 she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, note that her skin in warm and flushed and that she’s drowsy. You also note that she’s 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 learn
- She had some readings on her glucometer which were reading ‘high’
- She vomits almost every time she takes in fluid
- She hasn’t voided for a day but voided a great deal the day before
- She’s been sleeping long hours and finally woke up this morning and decided to seek care
Current labs and vital signs:
2. 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 Ringer’s (LR) IV stat
36 units NPH (Humulin N) and 20 units regular (Humulin R) insulin SQ now
CBC 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 air
1800 calorie, carbohydrate controlled diet
Bed rest
Acetaminophen (Tylenol) 650 mg orally Q4 hrs PRN
Furosemide (Lasix) 60 mg IV push now
Urinary output every hour
VS every shift
The 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/referenceebooks
Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa
Case study adapted from:
Harding, M.M. & Snyder, J.S. (2015). Winningham’s 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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