Diabetic Ketoacidosis Case Study Essay

Diabetic Ketoacidosis Case Study

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Patient Profile
N.B., a 34-yr-old Native American man, was admitted
to the emergency department after he was found
unconscious by his wife in their home.
Subjective Data (Provided by Wife)
• Was diagnosed with type 1 diabetes mellitus
12 mo ago
• Was taking 50 U/day of insulin: 5 U of lispro insulin
with breakfast, 5 U with lunch, and 10 U with
dinner plus 30 U of glargine insulin at bedtime
• Has history of gastroenteritis for 1 wk with vomiting and anorexia
• Stopped taking insulin 2 days ago when he was unable to eat
Objective Data
Physical Examination
• Breathing is deep and rapid
• Fruity acetone smell on breath
• Skin flushed and dry
Diagnostic Studies
• Blood glucose level 730 mg/dL (40.5 mmol/L)
• Blood pH 7.26
Discussion Questions
1. Briefly explain the pathophysiology of the development of diabetic
ketoacidosis (DKA) in this patient.
2. What clinical manifestations of DKA does this patient exhibit?
3. What factors precipitated this patient’s DKA?
4. Priority Decision: What is the priority nursing intervention for N.B.?
5. What distinguishes this case history from one of hyperosmolar hyperglycemic syndrome (HHS) or hypoglycemia?
6. Priority Decision: What is the priority teaching that should be done
with this patient and his family?
7. What role should N.B.’s wife have in the management of his diabetes?
8. Priority Decision: Based on the assessment data presented, what are
the priority nursing diagnoses? Are there any collaborative problems?
9. Evidence-Based Practice: N.B.’s wife asks you if she should have
given her husband insulin when he got sick. How would you respond?

Grading Rubrics

Critical Elements

Distinguished

(100%)

Proficient

(85%)

Basic

(70%)

Below Expectations

(50%)

Non-Performance

(0%)

Thesis Statement

Raises the strongest objection to the thesis presented in the assignment. The objection is strongly grounded in research and logical reasoning.

Raises a plausible objection to the thesis presented in the assignment. The objection is mostly grounded in research and logical reasoning.

Raises an objection to the thesis presented in the assignment. The objection is somewhat grounded in research and logical reasoning.

Attempts to raise an objection to the thesis presented in the assignment. The objection is minimally grounded in research and logical reasoning.

The objection to the thesis is either nonexistent or lacks the components described in the assignment instructions.

Counter Argument

Provides a strong, thorough rebuttal to the objection. The rebuttal effectively demonstrates that the thesis can withstand the objection and applies the principles of charity and accuracy.

Provides a rebuttal to the objection. The rebuttal mostly demonstrates that the thesis can withstand the objection and mostly applies the principles of charity and accuracy.

Provides a limited rebuttal to the objection. The rebuttal somewhat demonstrates that the thesis can withstand the objection and somewhat applies the principles of charity and accuracy.

Attempts to provide a rebuttal to the objection; however, the rebuttal minimally demonstrates that the thesis can withstand the objection and does not apply the principles of charity and accuracy.

The rebuttal is either nonexistent or lacks the components described in the assignment instructions.

Conclusion

– Provides clear and concise closing remarks that comprehensively summarize the essay. The remarks consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem.

Provides closing remarks that summarize the essay. The remarks mostly consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are somewhat unclear.

Provides closing remarks that minimally summarizes the essay. The remarks minimally consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problems. The closing remarks are unclear and/or vague.

Attempts to provide closing remarks that summarize the essay, however, the remarks do not consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are unclear and vague.

The closing remarks are either nonexistent or lack the components described in the assignment instructions.

Written Communication: Context of and Purpose for Writing

Demonstrates methodical application of organization and presentation of content. The purpose of the writing is evident and easy to understand. Summaries, quotes, and/or paraphrases fit naturally into the sentences and paragraphs. Paper flows smoothly.

Demonstrates sufficient application of organization and presentation of content. The purpose of the writing is, for the most part, clear and easy to understand. There are some problems with the blending of summaries, paraphrases, and quotes. Paper flows somewhat smoothly.

Demonstrates a limited understanding of organization and presentation of content in written work. The purpose of the writing is somewhat evident but may not be integrated throughout the assignment. There are many problems with the blending of summaries, paraphrases, and quotes. Paper does not flow smoothly in all sections.

Organization and presentation of content are extremely limited. The purpose of the writing is unclear. There is little or no blending of summaries, paraphrases, and quotes. Paper does not flow smoothly when read.