Reference no: EM133590997

Question: A 20-year-old American Indian female college student with type 1 diabetes mellitus who uses an insulin pump becomes markedly confused, and a friend calls 911. Her friend states that they have been camping all weekend, and she thinks her friend may have gotten too hot while hiking in the heat and humidity. The friend reports they have never hiked before. She also reports she noticed her friend "messing with her pump" more than normal and the pump seemed to be alarming often. She remembers that her friend was stopping to urinate more often. In the emergency department, she is tachypneic, breathing deeply at a rate of 24 breaths/minute. She is normotensive, but her heart rate is elevated at 112 beats/minute. On examination, she is oriented only to her name and is delirious. Her insulin pump is not registering and is poorly adhered with some clear fluid leaking at the insertion site. A fruity breath odor is noted with dry oral mucosa. There are no overt signs of trauma. Her skin is hot and dry with poor turgor. Serum chemistries reveal a glucose level of 550 mg/dL, potassium of 3.7 mEq/dL, and sodium of 132 mEq/L. Her serum osmolality is 298. Urine dipstick is grossly positive for glucose and ketones. It is quickly determined that she is in diabetic ketoacidosis.

What factors could be involved in this young woman's case? (List five - you may also think 'outside' the box.
What factors would cause her to have a fluid volume deficit?
What is the name and underlying physiologic cause for her respiratory pattern? (Name - 5 points
What are potential electrolyte imbalances noted in her case? What other labs would you anticipate or values to monitor?
What treatment would you anticipate for this client's plan-of-care? Pharmacological and nonpharmacological/educational?