The assignment discusses the case study of a patient suffering from severe Diabetic Ketoacidosis (DKA), including symptoms, assessment, treatment, and nursing considerations.
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Running head: CASE STUDY ON DIABETIC KETOACIDOSIS Case Study on Diabetic Ketoacidosis Name of the Student Name of the University Author Note
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1 CASE STUDY ON DIABETIC KETOACIDOSIS The assignment discusses the case study of Peter Brown, whon is a 62 years old female, suffering from severe Diabetic Ketoacidosis (DKA). The condition is a potentially life-threatening in which complication in diabetes type 1 which occurs due to the insulin deficiency in the body. Patient has reported about frequent urination. In addition to this, she has also reported that she had severe abdominal pain and the issue of vomiting. From the assessment, it is observed that she is obese and suffering from hypertension for the last three years. She was previously employed in a food and beverage industry as a quality controller. She is living alone in her house as her husband passed away a few years ago.She complained to the care provider that, she has recently started to feel depressed and isolated herself from society due to her obese condition. From the assessment, it was observed that the patient has blood glucose levels of 19 mMol/ L and the blood ketone level of the patient diagnosed was almost 4.2 mmol/L which is a severe sign of DKA (Gosmanov, Gosmanova, & Dillard-Cannon, 2014).In addition, her first respiratory rate was also reported. After admitting to the hospital, the patient was given intravenous fluid in order to rehydrate the body of the patient, as due to frequent urination and vomiting a huge amount of fluid has lost from the body of the patient (Misra & Oliver, 2015).According to Umpierrez and Korytkowski (2016), restoration of essential nutrients and fluids are very crucial in the treatment of DKA patients. In this case, as the patient has severe fluid and nutrient losses from the body,the above-mentioned care process is required to be provided to the patient. As a part of the nursing consideration, it can be said that the nurse should primarily focus on the diabetes management and then the nurse should concentrate on the management ofpsychologicalconditionofthepatient(Petersetal.,2016).Asprimarycareof management, the nurse should discuss with the doctor and administer the patient with insulin
2 CASE STUDY ON DIABETIC KETOACIDOSIS as a part of the diabetesmanagement as it is known that insulin deficiencyis associated with DKA (Andrade‐Castellanos et al., 2016). After using this care plan the nurse regularly monitors the blood glucose level of the patients in order to check the progress of the condition (Agiostratidou, et al., 2016). In addition to this, she should observe the vital signs like urination, vomiting as these are associated with the fluid imbalance in the body (Dhatariya, 2014).However, in case of severe breathing problem the nurse may use oxygen therapy for the patient (John, 2015).In order to address the issue of social isolation, the nurse may take support from the counselors who will address the issue of social isolation and depression (Fisher, et al., 2016). The above-mentioned intervention is needed to be applied as it is observed in various studies that, the issue of depression is associated with the problem of diabetes (Sudhakaran & Surani., 2015). On the other hand, insulin therapy will help to address the issue of insulin of deficiency in the body of the patient with DKA.It is also importanttoinvolvetheotherstakeholderforPeterBrown,suchasdietitians, physiotherapist, specialist and her family members in order to design a care plan which would help to address her problems in a better way.
3 CASE STUDY ON DIABETIC KETOACIDOSIS References Agiostratidou, G., Anhalt, H., Ball, D., Blonde, L., Gourgari, E., Harriman, K. N., ... & Peters, A. (2017). Standardizing clinically meaningful outcome measures beyond HbA1c for type 1 diabetes: a consensus report of the American Association of ClinicalEndocrinologists, the AmericanAssociation of DiabetesEducators, the American Diabetes Association, the Endocrine Society, JDRF International, The Leona M. and Harry B. Helmsley Charitable Trust, the Pediatric Endocrine Society, andtheT1DExchange.DiabetesCare,40(12),1622-1630. https://doi.org/10.2337/dc17-1624 Andrade‐Castellanos, C. A., Colunga‐Lozano, L. E., Delgado‐Figueroa, N., & Gonzalez‐ Padilla, D. A. (2016). Subcutaneous rapid‐acting insulin analogues for diabetic ketoacidosis.CochraneDatabaseofSystematicReviews,(1).Retrievedfrom: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011281.pub2/ abstract Dhatariya,K.(2014).Diabeticketoacidosisandhyperosmolarcrisisin adults.Medicine,42(12), 723-726.https://doi.org/10.1016/j.mpmed.2014.09.012 Fisher, L., Hessler, D. M., Polonsky, W. H., Masharani, U., Peters, A. L., Blumer, I., & Strycker, L. A. (2016). Prevalence of depression in type 1 diabetes and the problem of over‐diagnosis.Diabeticmedicine,33(11),1590-1597. https://doi.org/10.1111/dme.12973 Gosmanov, A. R., Gosmanova, E. O., & Dillard-Cannon, E. (2014). Management of adult diabeticketoacidosis.Diabetes,metabolicsyndrome,andobesity:targetsand therapy,7, 255.10.2147/DMSO.S50516
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4 CASE STUDY ON DIABETIC KETOACIDOSIS John, E. (2015). Hall. Guyton and Hall textbook of medical physiology.Elsevier,20, 220- 224. Retrieved from: https://www.edouniversity.edu.ng/oerrepository/articles/cardiovascular_physiology.p df Misra,S.,&Oliver,N.S.(2015).Diabeticketoacidosisinadults.Bmj,351, h5660.https://doi.org/10.1136/bmj.h5660 Peters, A. L., Henry, R. R., Thakkar, P., Tong, C., & Alba, M. (2016). Diabetic ketoacidosis with canagliflozin, a sodium–glucose cotransporter 2 inhibitor, in patients with type 1 diabetes.DiabetesCare,39(4),532-538.Retrievedfrom: http://care.diabetesjournals.org/content/diacare/39/4/532.full.pdf Sudhakaran, S., & Surani, S. R. (2015). Guidelines for perioperative management of the diabeticpatient.Surgeryresearchandpractice,2015. http://dx.doi.org/10.1155/2015/284063 Umpierrez,G.,&Korytkowski,M.(2016).Diabeticemergencies—ketoacidosis, hyperglycaemichyperosmolarstateandhypoglycaemia.Naturereviews Endocrinology,12(4),222.Retrievedfrom: https://www.nature.com/articles/nrendo.2016.15