Diabetes Study on Symptoms and Treatment

QUESTION

Using the case study below, write a concise APA paper using bullet points.

Include an APA style Title page,

3-8 BRIEF BULLET POINTS FOR EACH SECTION,

an in-text citation, and

an APA style Reference page.

Use the following four, Level 1 headings within your paper:

Psychopathology of the Disorder

Etiology of the disorder A.B. is experiencing.

Clinical Manifestations of the disorder A.B. is experiencing

Expected treatment options for A.B. (Based on the psychopathology of the disorder and clinical manifestations).

A 21-year-old female (A.B.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill.

She is unable to keep any food down. She only tolerated sips of water and juices.

Since she’s been unable to eat, she hasn’t taken any long or rapid-acting insulin as directed.

While helping A.B. from the lobby to the examining room you note that she’s unsteady on her feet, her skin is warm and flushed, and she’s drowsy. You also note that she’s breathing rapidly, and her breath has a sweet/fruity odor.

A.B. has a challenge answering questions but keeps asking for water to drink.

You get more information from A.B. and learn the following:

• She had some readings on her glucometer which were reading ‘high.’
• She vomits almost every time she takes in fluid
• She hasn’t voided for a day but, she voided a great deal yesterday.
• She’s been sleeping long hours and finally woke up this morning and decided to seek care.

Current labs and vital signs:

BP: 88/46

HR: 132 BPM

RR: 30/min, deep

Temperature: 101.3 F

Glucose 330 mg/dL

Potassium 6.2 mEq/L

Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.

ANSWER

Diabetes Case Study Assignment

Introduction

E.M., a 21-year-old woman, seeks immediate medical aid presenting with indications of nausea, retching, dysentery, and high body temperature persisting for three days. She acknowledges her condition of Type I diabetes and confesses the lack of control over her glucose levels since the onset of her malaise. E.M. finds it impossible to retain any nutrients and can only bear occasional gulps of water and fruit extracts. Moreover, she has neglected her recommended dose of both long-acting and short-acting insulin due to her persistent anorexia. During the medical evaluation, it is observed that she displays an unstable gait, possesses warm and reddened skin, and exhibits lethargy. She also demonstrates tachypnea, and her breath emits a sweet/fruity scent. She struggles to respond to inquiries but recurrently requests water to satiate her thirst.

Psychopathology

The amassed information unequivocally suggests that E.M. is grappling with diabetic ketoacidosis (DKA). DKA is a grave repercussion of unmanaged diabetes mellitus, marked by the body’s generation of elevated ketone levels, a form of acid created when the body employs fat over glucose for energy production (Bhasin et al., 2023). This phenomenon arises due to a dearth of insulin, leading to a surge of glucose in the bloodstream instead of being utilized for energy production. Consequently, the body resorts to fat breakdown for energy, engendering the formation of ketones, which amass in the bloodstream, culminating in an acidic environment. DKA is customarily observed in individuals suffering from Type I diabetes, but it can also transpire in those diagnosed with Type II diabetes.

Etiology

The origins of diabetic ketoacidosis (DKA) are multifaceted, encompassing insulin deficit or resistance, amplified production of counter regulatory hormones, and escalated lipolysis. In the case of E.M., her inability to oversee her glucose concentrations amidst her sickness probably led to decreased insulin output and heightened insulin resistance. Insulin is indispensable for enabling glucose uptake by cells and inhibiting glucose production in the liver. In its absence, the body seeks alternative energy reservoirs, such as fatty acids, triggering lipolysis and the generation of ketone bodies (Palmer & Clegg, 2021). The elevated concentrations of ketone bodies, particularly beta-hydroxybutyrate, cause the bloodstream to become acidic, leading to metabolic acidosis.

Alongside insulin deficiency, other elements that can contribute to DKA include infections, trauma, surgery, and certain medications that escalate insulin resistance or counter regulatory hormone production, such as glucocorticoids. These elements can worsen insulin deficiency or resistance, culminating in the onset of DKA.

Clinical Manifestations of the disorder A.B. is experiencing

In the realm of health, the indications of Diabetic Ketoacidosis (DKA) can span from benign to harsh, possibly encompassing signs such as nausea, retching, abdominal discomfort, a distinct fruity-scented breath, disorientation, and dehydration (Arokiasamy et al., 2021). The accelerated respiration noted in the case of A.B. is the body’s endeavor to diminish blood acidity by expelling carbon dioxide via breath. Concurrently, dehydration may transpire due to the fluid loss from vomiting and diarrhea, leading to an imbalance in electrolytes. As observed in the case of A.B., an increased concentration of glucose in the bloodstream, accompanied by elevated ketone levels and diminished potassium levels, is indicative of DKA. Moreover, A.B.’s blood pressure and heart rate are heightened, likely as the body’s reaction to the acidic surroundings.

Expected Treatment

DKA treatment targets the reversal of the metabolic acidosis, rectifying the electrolyte imbalances, and pinpointing the root cause of the condition. The foremost remedy for DKA is insulin therapy, which resolves the underlying insulin scarcity or resistance (Warshauer et al., 2020). The introduction of insulin aids in reducing the production of ketone bodies, facilitates glucose absorption by cells, and curbs glucose production in the liver. Rapid-acting insulin, such as insulin lispro, is frequently employed initially to decrease blood glucose concentrations, followed by a continuous infusion of regular insulin to preserve normal blood glucose levels.

Additionally, replenishment of fluids and electrolytes constitutes a crucial aspect of DKA treatment. Patients suffering from DKA are often dehydrated and exhibit electrolyte imbalances due to the loss of fluids through retching and diarrhea. The restoration of fluids and electrolytes assists in correcting the imbalances and avert complications like hypotension, renal failure, and cardiac arrhythmias. The choice and pace of fluid replacement hinge on the patient’s fluid and electrolyte status, with isotonic saline being the most frequently utilized fluid.

Conclusion

Summing up, the symptoms and clinical representation of A.B. imply that she is grappling with diabetic ketoacidosis, a life-threatening complication of diabetes. The origin of this disorder includes insulin deficiency or resistance, leading to an overflow of fatty acids metabolized into ketones, resulting in acidosis. The clinical indications of DKA encompass gastrointestinal symptoms, dehydration, electrolyte imbalances, and altered mental status. The therapeutic approach for DKA incorporates immediate administration of insulin, fluids, and electrolyte replenishment. A.B.’s case underscores the importance of adequate diabetes management and urgent medical intervention when symptoms emerge to avert complications like DKA.

References

Arokiasamy, P., Salvi, S., & Selvamani, Y. (2021). Global burden of diabetes mellitus: prevalence, pattern, and trends. Handbook of Global Health, 495-538.https://link.springer.com/content/pdf/10.1007/978-3-030-45009-0_28.pdf

Bhasin, N., Sharma, M. K., Yadav, D. N., & Kumawat, D. M. K. Diabetes Ketoacidosis Is a Cause of Concern in Sodium-Glucose Co-Transporter-2 Inhibitors Medication.(2023). Int. J. Life Sci. Pharma Res, 13(1), P55-67.https://www.researchgate.net/profile/Namita-Bhasin/publication/366747163_Diabetes_Ketoacidosis_Is_a_Cause_of_Concern_in_Sodium-Glucose_Co-Transporter-2_Inhibitors_Medication_Pharmaceutical_Science-Pharmaceutics/links/63b9b805097c7832ca9aecd7/Diabetes-Ketoacidosis-Is-a-Cause-of-Concern-in-Sodium-Glucose-Co-Transporter-2-Inhibitors-Medication-Pharmaceutical-Science-Pharmaceutics.pdf

Palmer, B. F., & Clegg, D. J. (2021). Starvation ketosis and the kidney. American Journal of Nephrology, 52(6), 467-478.https://www.karger.com/Article/Abstract/517305

Warshauer JT, Bluestone JA, Anderson MS. New Frontiers in the Treatment of Type 1 Diabetes. Cell Metab. 2020;31(1):46-61.https://pubmed.ncbi.nlm.nih.gov/31839487/

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