Question

Lara Fielding, a 20-year-old college student, comes to the student health center with a 4-day history of flu-like symptoms. She reports feeling increasing fatigue, thirst, and nausea over the last 24 hours. Further assessment and lab work indicates that Lara is experiencing diabetic ketoacidosis (DKA). She is transferred to an acute care facility for treatment.

Lab work reveals that Lara's blood glucose is 370 mg/dl. plasma bicarbonate is 8 mEq/l, potassium is 5.2 mEq/l, and she has elevated ketones in her urine. The goals of treatment in DKA include correcting fluid imbalance and restoring normal pH, electrolytes and glucose.

1. develop a teaching plan for the patient /patient’s family. Indicate why you chose that topic and identify any obstacles they could face while implementing the teaching plan.

2. Find a scholarly (professional) journal article pertinent to the patient’s condition or care and provide a 1-2 paragraph summary of the article in your own words and cite the article in APA format.

3. Review clinical skills appropriate to your case study patient, consider potential complications or accommodations that might need to be made for this patient.

Answer 1

1:

• Take your insulin and diabetes medicines.
• Drink extra fluids to prevent dehydration.
• Try to eat as you normally do, with a focus on healthy food choices.
• Check your blood sugar at least every 3 to 4 hours.
• Check your temperature and pulse often
• Understand how to use diabetes devices, such as blood glucose meters, insulin pens, insulin pumps and continuous glucose monitors
• Adopt healthy eating habits through nutrition education, including meal-planning, weight-loss strategies and other disease-specific nutrition counseling
• Develop problem-solving strategies and skills to self-manage diabetes
• Monitor blood glucose and learn how to interpret and appropriately respond to the results
• Understand how their medications work, including their action, side effects, efficacy, toxicity, prescribed dosage and more
• Develop skills for handling stressful situations

3:

Correction of Fluid Loss
Insulin Therapy
Electrolyte Correction
Correction of Acid-Base Balance
Treatment of Concurrent Infection
Management of Treatment-Related Complications
Consultations
Long-Term Monitoring