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, her skin is 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 the following:
• 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
Vital Sign
Temperature 101.3° F (tympanic)
Blood pressure 88/46 mmHg
Heart rate 132 beats/minute
Respiratory rate 36 breaths/min, deep
Oxygen saturation % (SpO2) 91% on room air
Lab results
Serum glucose 657 mg/dl
Serum potassium 6.2 mEq/L
Urine ketones Positive
1. What is the disorder and its pathophysiology that you expect the health care provider to diagnose and treat?
2. Describe the etiology of the disorder A.M is experiencing.
3. Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
4. Identify and describe the expected treatment options for A.M. based on the disorder and clinical manifestations.
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