PLEASE no plagarism 25 year old male seen in the ED for the following symptoms; he is, hot, flush, complaining of thirst
Posted: Thu Jun 09, 2022 4:48 pm
PLEASE no plagarism
25 year old male seen in the ED for the following
symptoms; he is, hot, flush, complaining of thirst, states he has
been "peeing" a lot. He is lethargic, though arousable, has a
fruity breath odor and his friends who brought him in say that he
has been binging all weekend on beer and tequila at various
parties. He is thin, almost cachexic in
appearance.
Vital Signs: BP 90/40, HR 120, RR 35. Urine is very
pale, water like. The patient arouses enough to tell you that
he has been a insulin dependent diabetic since age 10 and he had
left his insulin at home in another city where he lives with his
parents. His usual daily dose is NPH 15 u with 5 units of regular
every morning, and 10 units of NPH at bedtime. His serum
blood glucose is 500 mg/dL; a glycated hemogloblin is 10.
Other labs are: serum creatinine 2.0; BUN 25; Serum potassium of
4.0
1. What is the most likely diagnosis? Describe
what will happen to the potassium once insulin is administered to
him? This is a critical time when this shift starts to occur,
what is the biggest problem that become an emergency?
2. Review current guidelines for insulin therapy in Type
1 diabetics. Does his current insulin replacement reflect
those recommendations? Explain how you would adjust it
25 year old male seen in the ED for the following
symptoms; he is, hot, flush, complaining of thirst, states he has
been "peeing" a lot. He is lethargic, though arousable, has a
fruity breath odor and his friends who brought him in say that he
has been binging all weekend on beer and tequila at various
parties. He is thin, almost cachexic in
appearance.
Vital Signs: BP 90/40, HR 120, RR 35. Urine is very
pale, water like. The patient arouses enough to tell you that
he has been a insulin dependent diabetic since age 10 and he had
left his insulin at home in another city where he lives with his
parents. His usual daily dose is NPH 15 u with 5 units of regular
every morning, and 10 units of NPH at bedtime. His serum
blood glucose is 500 mg/dL; a glycated hemogloblin is 10.
Other labs are: serum creatinine 2.0; BUN 25; Serum potassium of
4.0
1. What is the most likely diagnosis? Describe
what will happen to the potassium once insulin is administered to
him? This is a critical time when this shift starts to occur,
what is the biggest problem that become an emergency?
2. Review current guidelines for insulin therapy in Type
1 diabetics. Does his current insulin replacement reflect
those recommendations? Explain how you would adjust it