Case Study : Diabetic Ketoacidosis

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

At Yale New Haven on the medicine floor SLA 4, the nurse manager identified the need of education on both the hyperglycemia and diabetic ketoacidosis protocols. The nurses and doctors were not aware of the steps outlined in the protocol that needed to be followed. There have been several incidents across the hospital of orders not being correctly prescribed by physicians and nurses following through with these incorrect orders, therefore seriously effecting patient outcomes. Specifically on SLA 4 there was a recent incidence of a patient coming off of an

Diabetic ketoacidosis is an event which occurs when there is not enough insulin in the body to utilize sufficient amount of glucose needed to provide cells with energy; body then starts to use fatty acids as a fuel, which are converted to ketones in the liver. In healthy people who do not have diabetes, ketone bodies are produced in normal quantities and then successfully used by tissues as energy supply. This state is known as dietary ketosis and it is completely normal and may even provide health benefits. But in those who have diabetes, ketones are produced in enormous quantities and aren't used in full by cells, so they start to build up in the blood. Acids 3-hydroxybutyric acid and acetoacetic acid are produced rapidly causing decrease in buffering capacity of the blood and eventually depleting buffering systems (Manninen, 2004).

Classic symptoms of diabetes usually presented with newly diagnosed diabetics are: hyperglycaemia, polyuria, polydipsia, polyphagia, fatigue, blurred vision, headaches, and unexplained weight loss. Ketone bodies are found in the urine, this abnormal finding occurs when fatty acid by-products (acetones) are excreted in the urine. The ketones are present from a lack of the insulin hormone used to metabolize fats and carbohydrates. Diabetic ketoacidosis (DKA) is a life-threatening complication which results from minimal useful insulin hormone in the body, hypoglycaemia, or insufficient food intake (American Diabetes Association, 2008).

Diabetes ketoacidosis (DKA) primarily occurs in type 1 diabetes which is characterised by hyperglycaemia, polyuria, polydipsia, hyperventilation and dehydration (Mellitus, 2005).

Diabetic ketoacidosis (DKA) DKA and hyperosmolar hyperglycemic syndrome (HHS) occurs in 20 % of the elderly who have not previously been diagnosed with diabetes. HHS is more often found in the elderly, being precipitated by an acute illness or drug therapy (Childs, Cypress, & Spollett, 2009). DKA and HHS, are both similar in the aspect for a decrease in the effective concentration of insulin in conjunction with the counter regulatory hormones glucagon, cortisol, growth hormone and epinephrine. However, DKA and HHS differed in the driving force, degree of insulin deficiency, serum glucose levels, pH, serum osmolality and duration of symptoms (Childs, Cypress, & Spollett, 2009).

This paper will explore the history and hospital course of Mr. Z., a 23 year old Caucasian male who was admitted on October 11, 2016 to Massachusetts General Hospital for treatment of diabetic ketoacidosis (DKA) and new onset type 1 diabetes mellitus. DKA is an emergency situation that results in 100,000 hospitalizations in the US yearly, a 9% mortality rate, and treatments of reportedly 1 billion dollars per year (Katsilambros, Kanaka-Gantenbein, Liatis, Makrilakis, & Tentolouris, 2011). Presenting to the emergency room with DKA is the first manifestation of type 1 diabetes in 30% of cases (Katsilambros et al., 2011). This paper will examine Mr. Z.’s case presentation, pertinent medical history, diagnosis formulation, hospital management, intensive review of his medications, and discussion.

While diabetic ketoacidosis is typically associated with Type I diabetes mellitus, a subgroup of people with Type II DM may also be vulnerable, especially under conditions of physiologic stress, such as trauma or infection. The DKA-prone type II patients also tend to be males who have a family history of diabetes, newly diagnosed diabetes, blacks, Latinos, those who are middle-age, and

Diabetic Ketoacidosis (DKA) is an acute complication of uncontrolled glucose levels characterized by reduced levels of insulin and presence of ketones. It is a medical emergency and results can be detrimental if left untreated. DKA is commonly seen in patients with type 1 diabetes mellitus (type 1 DM). However, critically ill patients with type 2 diabetes mellitus (type 2 DM) such as trauma, surgery or infection, are also at risk for DKA (Ignatavicius & Workman, 2013). Patients with type 1 DM are predisposed to DKA if their underlying conditions are not diagnosed early and in some cases, they may experience similar signs and symptoms without actually developing DKA. Comorbidities involving parts of

By definition insulin is refer as a hormones which assumes a key in the regulation of blood glucose levels and an absence of insulin can lead to the improvement of the symptoms of diabetes (The global diabetes community, 2014). Decrease insulin concentrations trigger adipose tissue lipase causing lipolysis of triglycerides in glycerol and free fatty with consequent elevation of fatty acid transport into mitochondria where ketone body development happens (Keays, 2007). Understanding the significance of insulin serves to know more about how the body utilizes it for energy. As we know our body is made up of millions of cells, thusly to create energy, this cells need food in exceptionally straightforward structure (Type 2 diabetes, 2014). When we eat or drink, a great part of the nourishment is broken down into a straightforward sugar called ‘glucose’. Basically, glucose is transported through the circulatory system to these body cells where it can be utilized to provide the energy the body requirements for daily exercise. The decrease of glucose levels in blood is caused when the amount of glucose in the blood ascents to certain level; hence, the pancreas discharge more insulin to push more glucose into cells. While to keep blood glucose levels from getting

Metabolic acidosis happens when the chemical balance of acids and bases in your blood gets thrown off. This can be triggered when the body; is producing too much acid, isn't getting rid of enough acid or doesn't have enough of a base to offset a normal amount of acid. When any of these occur, chemical reactions and processes in your body don't work right. Diabetics can suffer from a Metabolic acidosis know as Diabetic Ketoacidosis. Diabetic Ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are incapable to get the sugar (glucose) they need for energy because there is not adequate insulin. When the sugar cannot enter into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood

The problem with Mrs. Brown, is that she is found with Diabetic Ketoacidosis. Diabetic Ketoacidosis is when your body produces high glucose acid in the body. In this case, Mrs. Brown has high blood glucose. Meaning that she is metabolically acidosis. What her body is trying to attempt is to exhale the excessiveness of carbon dioxide in her body. Which having an excess of CO increases her respiratory rate. Mrs. Brown’s kidneys are reabsorbing bicarbonate ions at that very moment but is not enough to fight the

Introduction: Diabetic Ketoacidosis (DKA) is an emergent metabolic complication especially in type 1 diabetes. DKA is a catabolic state characterized by low-insulin level and bodies’ inability to utilize glucose despite hyperglycemia. DKA and thyrotoxicosis can have overlapping manifestations. Thus, diagnosis of thyrotoxicosis may be delayed in patients presenting with DKA. Hence, a careful clinical assessment of precipitating factors must be performed in all patients with DKA.

I am Barbara Ligons your nurse and I will be assisting Dr. Gupta in caring for your daughter Ellen. When Ellen came into the emergency room she was barely conscious. She complained about excessive vomiting, frequent urination, excessive thirst, seeing double, headaches, and feeling really tired for the last two days. From these observations Dr.Gupta suspects a serious diabetic complication called ketoacidosis. Ellen has complained of weight loss of 15lbs in the last month and I do see in her file she has a history of headaches, depression and urinary tract infections which is where bacteria are found in the urine. After reviewing her records I also observed that the last surgeries she has had was the removal of her

Diabetic Ketoacidosis (DKA) is a serious disease with complications that may have fatal results in some cases. DKA is defined as an insulin deficiency that occurs when glucose fails to enter insulin into muscles such as: liver and adipose tissue. When there is an accumulation of ketones, it leads to metabolic acidosis which causes nausea and vomiting, as a result fluid and electrolytes are lost (Gibbs). There are many complications of diabetic ketoacidosis, some of the most prevalent are: Cerebral Edema, Hypoglycemia, and Acute Pancreatitis.