S:This pa ent presented to the ED with Conceptual Care Map Lab Values/Diagnos c Tests

complaints of polyuria and polydipsia and BG of

593, urine tests showed glucose in the urine, so Student Name: Tessa Honeycu Pa ent: X Anion Gap:11
he was admi ed for observa on of DKA to the
ICU Age__77_____ Gender ____M____ Admission Date ______10/30/23________ NA: 143

B: This pa ent has a diagnosis of type 2 diabetes CODE Status __FC____ Allergies _Lisinopril____ Braden Score __14______ CL: 113
mellitus, severe neuropathy, orthosta c
hypertension, CKD, depression, hyperlipidemia Diet: Diabe c carb control Ac vity Min Assist X1, high fall risk K: 4.2

A:The pa ent is AXO4, with a pleasant a ect. Weight ____160____ Height _____5’8”____ Religion __None___ Co2:21
PERRLA. Wears hearing aids. On room air, all
___________________________________________________ Treatment/Procedures
lobes clear upon ausculta on, and in sinus
rhythm, on cardiac monitoring. 2/2 pulses with
Admi ng Diagnosis/Chief Complaint Insulin Drip
no edema in all extremi es. 18g in LAC, 20g RF,
placed on admission, DC 20g LF this am. Pa ent
is voiding in a urinal and having regular bowel
Diabe c Ketoacidosis Risk Factors
movements. Right toe amputa on in 2018, with
scabs to bilateral shins and forearms from PathPatho Flow Diagram
Flow Diagram Diabetes Mellitus
previous falls prior to admission. Mepalex on the
R elbow covering a wound. Pa ent is a high fall Interdisciplinary Collabora on
Disruption of cell pathways, leading to a decrease response to insulin
risk due to neuropathy and orthosta c with the cells, meaning there is more free glucose in the blood than
hypotension Q1 hour BG checks. Pa ent is calm what is normal
Endocrinologist, hospitalist,
and coopera ve pharmacy
The patient experiences The patient then goes on When a medication is too strong,
R: Insulin drip, Monitor Lab values, insulin replacement like in this case jardiance, it can
symptoms such as
I/O, bed alarm, polyuria, polydipsia, medication, so that their body lead to complications like diabetic
and polyphagia. can properly use glucose ketoacidosis

Medica ons In most cases, diabetic Psych./Soc./Economic Data

ketoacidosis means the patient In other cases, like this one, the
has a very high blood medication makes their body - Pa ent is reported having some
- 100 ml of D5 LR with insulin, 1.25 glucose(>600) and ketones in excreted glucose through the
units per hour the urine. This means there is a urine, so it stops producing insulin family issues, and is discouraged by
complete absence of insulin in leading to the body not getting his disease course.
- Glargine 60 units the body so the glucose cannot any energy from the glucose it has
be used at all. Discharge Teaching Needs
- Enoxaparin 40 mg IN both cases, this condition must be
treated with insulin drips and frequent - New insulin regimen treatment,
monitoring of blood sugars and educa on on how to keep blood
titration, otherwise this condition
leads to coma and death sugars low. How to recognize signs of
DKA.
Past Medical/Surgical History

Diabetes mellitus, Orthosta c hypotension, CKD, depression, hyperlipidemia,

ti
tti
ti
ti
ti
ti
ti
ti
ti
ti
tt
ti
ti
ti
ti
ti
ti
ti
tt
ti
ti
ti
ti
ff
ti
ti
ti