When caring for the patient with diabetes, which of the following acute complications requires immediate intervention?
1. The patient presents with vomiting, abdominal pain, and flushing.
2. The patient complains of burning in the feet and lower extremities.
3. The patient states his vision has decreased over the last several years.
4. The patient's creatinine is 1.1 mg/dl.
The patient presents with vomiting, abdominal pain, and flushing.
Rationale: Vomiting, flushed and dry skin, abdominal pain, and acetone odor to the breath are symptoms of diabetic ketoacidosis (DKA), which, if untreated, leads to severe dehydration and acidosis. Burning in the lower extremities may indicate diabetic neuropathy, a chronic complication of diabetes that can be treated, but not necessarily immediately. Decreased visual acuity is a chronic complication of diabetes due to retinopathy, macular degeneration, or cataracts. A creatinine of 1.1 mg/dL is normal and does not represent a complication of diabetes.
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