Insulin as prescribed or adhering to diabetic diet

Reference no: EM133729439

Question

The client is a 23-year-old African American male with type-1 diabetes who has not been taking his insulin as prescribed or adhering to a diabetic diet. The client presented to the emergency department with complaints of lethargy, abdominal pain, nausea, and malaise. Vital signs:

• Temperature: 98.6 F

• Pulse: 110 beats/minute

• Respirations: 32 breaths/minute

• Blood pressure: 90/60 mm Hg

• Oxygen saturation: 96% on room air Laboratory results:

• Serum glucose: 400 mg/dL (on arrival at the emergency department)

• Serum sodium (Na+): 125 mEq/L

• Serum potassium (K+): 6.5 mEq/L

• Serum chloride (Cl): 120 mEq/L

• Blood urea nitrogen (BUN): 39 mg/dl

• Serum creatinine (Cr): 1.7 mg/dl

• Urinalysis - positive for ketones Arterial blood gas (ABG) results:

• pH: 7.30

• PaCO2: 33 mm Hg

• PaO2: 95 mm Hg

• HCO3: 19 mEq/L The client is admitted to the intensive care unit, and you are the nurse assigned to the client.

Questions:

1 Based on an interpretation of the ABG results, what acid-base imbalance is occurring?

2 What nursing assessment findings are expected?

3 Describe strategies for safe, effective multidimensional nursing care of the client.

Include rationale to support the strategies identified.

Reference no: EM133729439

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