Case Presentation: Dka

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UNIVERSITY OF MAKATI
College of Allied Health Studies – Center of Nursing
J.P. Rizal fExtension, West Rembo, Makati City

A Case Presentation
On

DIABETIC KETOACEDOSIS

In Partial Fulfillment of the Requirements in
Medical and Surgical Nursing I

Submitted By:

Biag, Ranilo
Dickman, Heidi
Dusanic, Lovelyn
Kuizon, Jaime
Valdez, Annalissa

January 22, 2012

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TABLE OF CONTENTS

CHAPTER 1: INTRODUCTION4 – 5
Significance of the Study5
Objectives6

CHAPTER 2: HEALTH HISTORY
I. Patient’s Profile7
II. Chief Complaint7
III. History of Present Illness7
IV. Past medical History 7
V. Ob-Gyne History8
VI. Family Medical History8
VII. Personal and Social History8

CHAPTER 3: PHYSICAL ASSESSMENT9 – 11

CHAPTER 4: REVIEW OF SYSTEMS12 – 13

CHAPTER 5: MEDICAL AND NURSING DIAGNOSIS14
CHAPTER 6: LABORATORY EXAMS15 – 18
CHAPTER 7: COURSE IN THE WARD19

CHAPTER 8: ANATOMY AND PHYSIOLOGY20 – 24

CHAPTER 9: DIFFERENTIAL DIAGNOSIS25

CHAPTER 10: PATHOPHYSIOLOGY26 – 27

CHAPTER 11: NURSING CARE PLAN28 – 41

CHAPTER 12: DRUG STUDY42 – 48

CHAPTER 13:DISCHARGE PLAN49

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Chapter 1: INTRODUCTION

Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). There are three main types of diabetes:

* Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.) * Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. (Formerly referred to as non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes.) * Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM. (1)

In the Philippines, according to the Department of Health (DOH), an estimated four million Filipinos suffer from diabetes. It appears that most Filipinos suffer from Type 2 Diabetes Mellitus. Early signs are lethargy, extreme thirst, and frequent urination. Other symptoms may include sudden weight loss, slow wound healing, urinary tract infections, gum disease, or blurred vision. It is not unusual for Type II diabetes to be detected while a patient is seeing a doctor about another health concern that is actually being caused by the yet undiagnosed diabetes.

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication in patients with diabetes mellitus. It happens predominantly in those with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances. DKA results from a shortage of insulin; in response the body switches to burning fatty acids and producing acidic ketone bodies that cause most of the symptoms and complications. (2) DKA may be the first symptom of previously undiagnosed diabetes, but it may also occur in known diabetics due to a variety of causes, such as intercurrent illness or poor compliance with insulin therapy. Vomiting, dehydration, deep gasping breathing, confusion and occasionally coma are typical symptoms. DKA is diagnosed with blood and urine tests; it is...
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