Diabetic Ketoacidosis Essay

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Introduction This case study is based on Diabetic Ketoacidosis (DKA). It aims to explore the pathophysiolgy at cellular level and the relationship to signs and symptoms. Finally, this concludes with collaborative care and strategies to manage the condition. Megan, 32 year old female is brought to the emergency department by ambulance after being found drowsy. Megan appears with fruity breath and had 3 episodes of vomiting. She experience dizziness, nausea, anorexia and abdominal pain. The respiratory rate is 32 bpm and the patient is receiving 5L of oxygen via Hudson mask. The heart rate is 120bpm and blood pressure is 90/60mmHg. GCS is 11/15, oxygen saturation is 97% and temperature is 35.8*C. These clinical manifestations could either be due to systematic inflammatory disease or a process of another disease. Primary diagnosis is impossible until further investigations and physical examination is carried out. Initially, a history is collected from the patient. There was no evidence of wound and Megan has not travelled for many years. Medical history describes healthy female lives with husband and 2 children without any history of smoking or alcohol consumption. On examination, the patient appears lethargic and dehydrated. Laboratory investigations have shown the signs of severe metabolic acidosis. These include decreased pH level (7.20), low bicarbonate level (13mg/dl), elevated glucose (280mg/dl) and anion gap (>10). Urine analysis shows the presence of glucose and ketones. Other investigations are serum ketones, electrolytes, complete blood count, blood culture, blood urea nitrogen and creatinine. Elevated blood and urine glucose level associated with the presence of ketone bodies in the urine are warning signs of DKA. The probable causes to develop DKA in Megan might be the undiagnosed diabetes mellitus or dysfunction of pancreatic beta cells. Other

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