Larry's Ketoacidosis Case Study

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Larry 's ketoacidosis was resolved over the next few days and a further week on a medical floor, saw Larry stabilized on his previous insulin regime.

Answer the following questions pertaining to the case:
1. Based on the pathophysiology
a. Give reasons for Larry 's reported admission symptoms of muscle weakness, decreased skin turgor, tachycardia and hypotension.
b. Describe how this situation can be corrected.
A. Mr. Secord may be experiencing the following symptoms due to dehydration and electrolyte imbalances. According to (Gould &Dyer,2011,p.126) in ketoacidosis the body shift from its normal fed metabolism ( using carbohydrates for fuel) to a fasting state (using fat for fuel), the resulting increase in blood sugar occurs. The authors
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A number of interventions can be used to help treat the symptoms. Mr Secord dehydration can be treated with IV infusion of fluids as well oral intake of fluids. In terms of the electrolyte imbalances a number of interventions can be used. (Silvestri, 2013, P.6597) states that if hyponatremia is accompanied by fluid volume deficit, IV sodium chloride is administered to restore sodium content along with fluid volume. The authors also state to treat hyperkalemia, oral potassium supplements should not be give and a potassium restricted diet should be initiated. (Silvestri,2013, P.6805) also makes reference to the fact that if renal function is impaired , prepare to administer sodium polystyrene sulfonate (kayexalate), a cation- exchange resin that promotes gastrointestinal sodium absorption and potassium …show more content…
On admission his nurse detected his fruity breath. Explain.
According to (Seeley et al,2008,p.644) acidosis is caused by rapid fat catabolism, when there is almost no effective insulin available, the body starts to break down stored fat for energy. Which results in increased levels of acetoacetic acid, which is converted to acetone and hydroxybutyric acid. These substances collectively are referred to as ketone bodies. The presence of excreted ketone bodies in the urine and in expired air (“acetone breath”) suggests that the person has diabetes mellitus.
8.What patient education would you provide to Larry in terms of recognizing the potential for the development of DKA to decrease his risk of critical care admissions in the future?

According to (Smeltzer et al,2010,p.1206) self-monitoring of blood glucose and learning how to respond to the results enable people with diabetes to adjust their treatment regimen to obtain optimal blood glucose control. This allows for detection and prevention of hypoglycemia and hyperglycemia and plays a crucial role in normalizing blood glucose levels, which in turn may reduce the risk of long term diabetic

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