Jeff is a 57-year-old male with a long history of type 1 diabetes. He takes insulin...

Jeff is a 57-year-old male with a long history of type 1 diabetes. He takes insulin to manage his diabetes, but has been having trouble maintaining steady blood glucose levels over the last two weeks. Jeff suffered a week-long case of influenza last month, but is otherwise healthy. This morning, he began vomiting upon waking. This was followed by extreme abdominal pain and extreme thirst. He called his endocrinologist, who told him that he needs to seek emergency care.

1. Given Jeff’s history of type 1 diabetes, which of the following conditions is he most likely experiencing?

		a. Diabetic ketoacidosis
		b. Metabolic alkalosis
		c. Respiratory alkalosis
		d. Diabetic alkalosis

2. Diabetic ketoacidosis is a type of respiratory acidosis.

True

False

3. If Jeff has diabetic ketoacidosis, which of the following symptoms may he also be experiencing?

		a. Infrequent urination
		b. Deep, rapid breathing
		c. Increased energy
		d. Increased salivation

4. Briefly explain why Jeff has a feeling of extreme thirst.

Expert Solution

1. Diabetic ketoacidosis.

Diabetic ketoacidosis is serious complication of type 1 diabetes, diabetes ketoacidosis happen when your blood sugar is very high and acidic substance like ketone builds up to dangerous levels in your body.

2. False

Diabetes ketoacidosis is type of metabolic acidosis, in diabetic ketoacidosis the Ph becomes less (around 7.3) and it causes low level of serum bicarbonate (less than 18meq/lit) which denotes that person is suffering from metabolic acidosis.

3. Deep, rapid breathing.

In diabetes ketoacidosis because of the symptom of metabolic acidosis, the patint experiences deep, rapid breathing.

4. In diabetes there is high concentration of glucose in blood over long period of time and the body is not able to pick up glucose from water in your kidneys, because of which osmotic pressure builds up, finally the osmotic pressure is so high that water can no longer be absorbed back into your blood stream causing extreme thirst. Diabetic ketoacidosis causes frequent urination because of which body becomes dehydrated fast resulting in excessive thirst.

Sydney Mullin answered 2 years ago

A 42 year-old male with history of insulin dependent diabetes has an appendectomy secondary to appendicitis....

A 42 year-old male with history of insulin dependent diabetes has an appendectomy secondary to appendicitis. Upon his arrival home, he noted increasing abdominal distention, fever, heavy breathing, shortness of breath and palpitations. He presented to the emergency department with pronounced abdominal distention, hypotension and altered mental status. His labs reveal a leukocytosis, bandemia, anion gap, positive blood cultures x2, creatinine elevation and hyperglycemia. 1. What is the primary diagnosis for this patient? Support your answer using the pathophysiology of...

James is a 51-year-old male Hispanic truck driver with a long history of diabetes and hypertension....

James is a 51-year-old male Hispanic truck driver with a long history of diabetes and hypertension. His current medication regimen is Lisinopril 20mg QD, metformin 1000mg QD, Lipitor 40mg QHS, and ASA 81mg QD. His A1C is 7, BP is 144/80, total cholesterol is 266, HDL 44, LDL 177, and Trig 199. What other information should you know about this patient to feel confident that his care is fairly well optimized? What parameters would you like to see improved? What...

Carl Rogers is a 67-year-old African American male with a 20-year history of type II diabetes...

Carl Rogers is a 67-year-old African American male with a 20-year history of type II diabetes mellitus. On Tuesday at 1530, he was directly admitted from his physician’s office to the medical unit with a stage II nonhealing ulcer on his right heel. The nursing admission paperwork has been completed, and pain medication has been administered. Additional orders for a dressing change and insulin administration have been written but not yet implemented. The scenario takes place on Tuesday at 1700.

John Taylor is a 68-year-old African American male with a history of type II diabetes, coronary...

John Taylor is a 68-year-old African American male with a history of type II diabetes, coronary artery disease and hypertension. He came to the emergency department (ED) triage window because he felt crummy, complaining of a headache, runny nose, feeling weaker, “achy all over” and hot to the touch and sweaty the past two days. When he woke up this morning, he no longer felt hot but began to develop a persistent “nagging cough” that continued to get worse throughout...

Skyler Hansen is an 18-year-old male diagnosed with type 1 diabetes 6 months ago. He was...

Skyler Hansen is an 18-year-old male diagnosed with type 1 diabetes 6 months ago. He was brought to the Emergency Department by his friends. The friends report that he started acting "weird" while they were playing basketball. He has not eaten anything for 5 hours. Skyler told them that he felt lightheaded and was going to lie down on the cement. They became nervous and decided to bring him in to the Emergency Department. The patient is drowsy, wakes with...

Mr. JS is a 69 yr old male with a history of obesity, type 2 diabetes,...

Mr. JS is a 69 yr old male with a history of obesity, type 2 diabetes, and hypertension. He is 3 mo poststroke and has gone through basic physical therapy. He has right-side hemiplegia, speech impediment, and depression. His resting BP is 150/90. Medications: Ticlopidine, hydrochlorothiazide, and glucophage. Mr. JS reported to his physician with numbness, dizziness, motor function impairment on the right side of his body, and vision problems. The patient was referred, and stroke was confirmed and diagnosed...

A 57 year-old male with history of HTN and HLP presents to your office with complaints...

A 57 year-old male with history of HTN and HLP presents to your office with complaints of transient chest pain during exertion. He denies associated nausea, diaphoresis however does complain of increase shortness of breath and dyspnea on exertion. His chest pain is substernal and does not radiate and seems to alleviate after 5-10 minutes with rest. The last occurrence of pain was one week ago. Pt denies palpitations, near syncope or syncopal episodes. 1. How would you classify the...

Peter Smith, a 73-year-old male with mild Type 2 diabetes, calls to schedule an appointment. He...

Peter Smith, a 73-year-old male with mild Type 2 diabetes, calls to schedule an appointment. He states that he is feeling very anxious and fatigued, and is having difficulty eating and sleeping. He arrives at the clinic with his wife and needs to check in. During the patient interview, he states that he wakes up in the middle of the night, almost nightly. He also has many nights when he cannot even fall asleep. In addition, he has lost about...

my 61 year old Male patient with type 1 diabetes, CRF and retinopathy, who is in...

my 61 year old Male patient with type 1 diabetes, CRF and retinopathy, who is in a pre dialysis condition, is sick of his exchange diet, what can I recomened to him ?

A 23-year-old male with Type 1 diabetes presents to the ER complaining of fatigue and malaise....

A 23-year-old male with Type 1 diabetes presents to the ER complaining of fatigue and malaise. He tells you he has skipped his insulin injections the previous two days. His labs are: PH 7.10 Na 140 BUN 35 PCO2 10 K 4.1 Crt 1.1 PO2 112 Cl 105 BS 845 HCO3 4 CO2 5 + ketonemia

Question