Case Study : Diabetic Ketoacidosis

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Case Study: Diabetic Ketoacidosis
Diabetic Ketoacidosis (DKA) is a disease state, most often seen in individuals with Type I Diabetes. While it most often results from uncontrolled insulin levels, young children can often present in diabetic ketoacidosis as the initial presentation of undiagnosed type I Diabetes. The major symptoms of Type I Diabetes, polydipsia, polyphagia, and polyuria, are often subtle and can be normal in growing children (Urden, Stacy & Lough, 2014; Wilson, 2012). Unless alert to the symptoms of Diabetes they can often be overlooked until severe enough to warrant immediate medical attention.
While typical healthy individuals use insulin to draw sugar into their cells for energy usage,
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Case Study
Patient G.M. is a four-year-old female from a middle class family living in San Diego. She originally presented with her mother and father to her general practitioner with lethargy and several vomiting episodes in the past few days. Her father stated concern after realizing her frequent urination in the past week. Her vital signs upon initial assessment were HR 140 RR 22 Temperature 102.7 degrees Fahrenheit, BP 70/62, O2 saturation 97%, 32 pounds, and 40 inches tall. Her General practitioner was concerned about type I diabetes and performed a blood sugar check. Upon assessment the monitor read HI, indicating that the level was above 500 and too high for the monitor to read. The doctor informed them she needed immediate treated in the closest pediatric ER due to the potential for diabetic ketoacidosis. G.M. was then immediately transferred to Rady Children’s hospital Emergency Room by her parents. Upon nursing assessment she presented with vital signs within the same range from her clinic visit. These were repeated every fifteen minutes until stable. Her skin was flushed and diaphoretic. Mucous membranes appeared dry with significant skin cracking around the mouth. Patient was alert and oriented times three and pupils were equal, round, and reactive to light and accommodation. Her breath sounds were clear and equal bilaterally, with no adventitious sounds noted. However, patient G.M. appeared to have
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