¶ … drowsy, confused, pale sweaty detect a fruity odour breath. You initiate a MET call a set vital signs a BGL. Questions 1 What complications occurring Tanya? Connect signs symptoms? 2 What pathophysiology complication? 3 What blood glucose reading situation ? 4 What nursing interventions required complication? 100 WORDS EACH 1 reference Farrell & Dempsey 2014 Smeltzer Bare textbook medical surgical nursing 3rd edition.
Tonya is suffering from diabetic ketoacidosis. This condition, also known as DKA, generally occurs in patients that have Diabetes Mellitus 1 or 2. The most prevalent precipitating factors include non-compliance with insulin therapy, infection, or a stressful event like a myocardial infarction or undergoing surgery. A key indicator is the fact that, upon assessment, in was noted that Tonya's breath had a fruity odor to it. This is a characteristic trait that can distinguish DKA from other pathophysiologic causes. If untreated, DKA can quickly turn into a diabetic coma. The change in Tonya's mental status indicates a need for immediate intervention. (Porth, 2005)
2. All of our cells metabolize glucose for energy. Glucose, however, is unable to get into the cells without the help of insulin. When there is a shortage of insulin, there becomes a back-up of glucose in the blood. With the absence of glucose, the cells begin to metabolize fat instead; forming ketones (protein). Acetone is also created, which causes the "fruity" odor in the breath. (Porth, 2005) With the limited availability of extracellular insulin and intracellular glucose, extreme fatigue and weakness may occur. Confusion can result from changes in Na+ and K. As a result of dehydration; another common symptom of DKA.
3. Tonya's blood glucose is expected to be well over 250mg/dL to meet the requirements for DKA. (Porth, 2005) Blood Glucose readings are the quickest and easiest tests to perform on a patient who is in need of emergency intervention and unable to provide other specimens; however, urine is a good indicator as well. Proteinuria, protein in your urine, is indicative of DKA as it is a direct product of metabolized fat. Other tests that could be performed are bicarbonate and pH levels as well as plasma electrolytes like potassium, sodium, and calcium. A decrease in mental status is indicative of an electrolyte imbalance.
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