A Detailed Case Study Analysis: Diabetic Ketoacidosis (Peter Brown)

This case study focuses on Peter Brown, a 62-year-old female patient suffering from severe Diabetic Ketoacidosis (DKA), a life-threatening complication of type 1 diabetes. The study details her symptoms, including frequent urination, abdominal pain, and vomiting, along with her medical history of obesity and hypertension. Assessment revealed a blood glucose level of 19 mMol/L and a blood ketone level of 4.2 mmol/L, indicating severe DKA. The treatment plan includes intravenous fluids for rehydration and insulin therapy to address insulin deficiency. Nursing considerations emphasize diabetes management, including regular blood glucose monitoring and monitoring vital signs, along with addressing the patient's psychological issues such as depression. Collaboration with other healthcare professionals like dietitians and counselors is recommended for a holistic approach to patient care. The study references several research papers to support the treatment and care approaches for DKA.

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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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
of psychological condition of the patient (Peters et al., 2016). As primary care of
management, the nurse should discuss with the doctor and administer the patient with insulin

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CASE STUDY ON DIABETIC KETOACIDOSIS
as a part of the diabetes management as it is known that insulin deficiency is 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
important to involve the other stakeholder for Peter Brown, such as dietitians,
physiotherapist, specialist and her family members in order to design a care plan which
would help to address her problems in a better way.

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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
Clinical Endocrinologists, the American Association of Diabetes Educators, the
American Diabetes Association, the Endocrine Society, JDRF International, The
Leona M. and Harry B. Helmsley Charitable Trust, the Pediatric Endocrine Society,
and the T1D Exchange. Diabetes Care, 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. Cochrane Database of Systematic Reviews, (1). Retrieved from:
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011281.pub2/
abstract
Dhatariya, K. (2014). Diabetic ketoacidosis and hyperosmolar crisis in
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. Diabetic medicine, 33(11), 1590-1597.
https://doi.org/10.1111/dme.12973
Gosmanov, A. R., Gosmanova, E. O., & Dillard-Cannon, E. (2014). Management of adult
diabetic ketoacidosis. Diabetes, metabolic syndrome, and obesity: targets and
therapy, 7, 255. 10.2147/DMSO.S50516

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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). Diabetic ketoacidosis in adults. 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. Diabetes Care, 39(4), 532-538. Retrieved from:
http://care.diabetesjournals.org/content/diacare/39/4/532.full.pdf
Sudhakaran, S., & Surani, S. R. (2015). Guidelines for perioperative management of the
diabetic patient. Surgery research and practice, 2015.
http://dx.doi.org/10.1155/2015/284063
Umpierrez, G., & Korytkowski, M. (2016). Diabetic emergencies—ketoacidosis,
hyperglycaemic hyperosmolar state and hypoglycaemia. Nature reviews
Endocrinology, 12(4), 222. Retrieved from:
https://www.nature.com/articles/nrendo.2016.15