A 21 year old noncompliant male with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. His blood glucose was high, as well as his urine glucose, urine ketones, and serum ketones. His serum bicarbonate was <12 mEq/L. His respiration was exaggerated and his breath had an acetone odor. His blood pressure was 90/60 and his pulse weak and rapid. 1. Is this person experiencing ketoacidosis or insulin shock? Explain your answer. 2. Why is the serum bicarbonate low? 3. What is the acid-base status of this individual? 4. What is the cause of the dyspnea, hypotension, and tachycardia? 5. What type of treatment does this person need? Any help would be greatly appreciated. This assignment is due in the morning.
Medicine - 2 Answers
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1 :
diabetic ketoacidosis. i won't give you all the answers, but check wikipedia under "diabetic ketoacidosis". and any time you have a diabetic with a strange breath odor, this is probably DKA.
2 :
1 ketoacidosis 2. metabolic acidosis 3 acidosis stimulates breathing, and produces vasodilatation. Vasodilatation gives low BP 4. Mainly insulin, NaHCO3 IV, monitoring of electrolytes acid-base status and heart function
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