Dx Help: DM vs. DKA? - page 2

For starters, hello everyone! This is my first post on here (though I have spent much time stalking the site for answers throughout my 14 months of nursing school so far LOL) Well I am now in the... Read More

  1. by   GitanoRN
    Quote from Nursing_Mamacita
    By the way, here is what I went with:

    1.) Deficient Fluid Volume
    a. monitor VS: noting orthostatic BP changes, respiratory pattern, RR & quality, peripheral pulse quality
    b. measure strict I&O
    c. administer 0.9% NS as ordered

    2.) Unstable Blood Glucose
    a. perform blood glucose testing as ordered
    b. administer fast acting insulin if indicated as ordered
    c. monitor labs (i.e serum glucose, acetone, k, pH, HCO3-)

    3.) Risk for Injury
    a. follow facility protocol for safety measures (i.e bed in lowest position, call bell within reach, etc)
    b. assess LOC qh; orient as needed
    c. appoint sitter as necessary (SO, family member, volunteer)

    Unquestionably, someone has done their homework, you should be proud therefore, I shall wish you the very best in all of your future endeavors in your nursing career.....Aloha~
  2. by   Esme12
    I know I am late to the party.....nice job! Remember fluid and electrolytes and where the K is going to go while you replace the fluid and correct the glucose....your potassium will plummet giveing rise to arrythmias.

    Good luck!
  3. by   PunkBenRN
    Quote from Nursing_Mamacita
    Hello hey_suz!

    The summary of the simulation client:
    36 y/o male
    Presents to ED confused and agitated
    Dx'd with DM I 12 months prior
    48 U of insulin daily
    Had "the flu" for 5 days with nausea, vomitting and anorexia
    Stopped taking insulin 2 days ago because he was not eating
    Not to be a cynical jerk, but whenever I have DKA pt's it is almost always a non-compliant diabetic. Sometimes after a drinking binge, sometimes just refuse to acknowledge that diabetes affects them.

    Sorry, long night, ha
  4. by   Nursing_Mamacita
    Hey everyone! Quick follow up!

    I did really well in my simulation lab! All went smoothly and my instructor was pleased with my interventions! Thank you all for your help. Your responses were not in vain

  5. by   Esme12
  6. by   SHGR
    Hey Nursing_mamacita, thanks for coming back with an update! Congratulations! You have great critical thinking skills.
  7. by   Nursing_Mamacita
    Thank youu!

    Hey Nursing_mamacita, thanks for coming back with an update! Congratulations! You have great critical thinking skills.
    Thanks! Now if I could just sharpen my common sense!!