Reference no: EM133662600

Problem

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:

1. Temperature: 98.6 F
2. Pulse: 110 beats/minute
3. Respirations: 32 breaths/minute
4. Blood pressure: 90/60 mm Hg
5. Oxygen saturation: 96% on room air

Laboratory results:

1. Serum glucose: 400 mg/dL (on arrival at the emergency department)
2. Serum sodium (Na+): 125 mEq/L
3. Serum potassium (K+): 6.5 mEq/L
4. Serum chloride (Cl): 120 mEq/L
5. Blood urea nitrogen (BUN): 39 mg/dl
6. Serum creatinine (Cr): 1.7 mg/dl
7. Urinalysis - positive for ketones

Arterial blood gas (ABG) results:

1. pH: 7.30
2. PaCO2: 33 mm Hg
3. PaO2: 95 mm Hg
4. HCO3: 19 mEq/L

The client is admitted to the intensive care unit, and you are the nurse assigned to the client. Reply to the following questions:

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

II. What nursing assessment findings are expected?

III. Describe strategies for safe, effective multidimensional nursing care of the client. Include rationale to support the strategies identified.