Tom comes into the emergency room very lethargic. He's been vomiting for 2 days and hasn't eaten anything. His blood sugar is 692 mg/dL. He has ketones in his urine. He is diagnosed with ketoacidosis
a. What is diabetic ketoacidosis?
b. How is it treated, and what are the three main goals?
c. What is the source of the ketones in his urine?
d. What should be monitored?
Students' answers should include the following:
a. Blood glucose elevated, elevated pH of blood, ketones in blood and urine
b. Treatment is to reduce blood glucose levels, correct fluid and electrolyte balance, and clear urine and blood of ketones.
Give IV insulin, fluids, and potassium replacements.
c. Ketones' source is breakdown of fats in body.
d. Monitor cardiac rhythm for any dysrhythmias due to electrolyte imbalances, especially potassium levels, and check LOC, vital signs, and glucose levels.
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