You are working in an outpatient clinic when a mother brings in her…

Question Answered step-by-step You are working in an outpatient clinic when a mother brings in her… You are working in an outpatient clinic when a mother brings in her 20-year-old daughter, C.J., who has type I diabetes mellitus and has just returned from a trip to Mexico. She has had a 3-day fever and diarrhea with nausea and vomiting. She has been unable to eat and has tolerated only sips of fluid. Because she was unable to eat, she did not take her insulin as directed. You note C.J. is unsteady, so you take her to the examining room in a wheelchair. While assisting her onto the exam table, you note her skin is warm and flushed. Her respirations are deep and rapid, and her breath is fruity and sweet-smelling. C.J. is drowsy and unable to answer your questions. Her mother states, “She keeps telling me she’s so thirsty, but she can’t keep anything down.” 1.   List four pieces of additional information you need to elicit from C.J.’s mother. The mother tells you the following:”Her blood glucose monitor has been reading high.””C.J. has had sips of ginger ale, but that’s all.””She has been vomiting about every other time she drinks.””When she first got home, she went (voided) a lot, but yesterday she hardly went at all, and I don’t think she has gone today.””She went to bed early last night, and I could hardly wake her up this morning. That’s why I brought her in.” 2.   Describe the pathophysiology of diabetic ketoacidosis (DKA). 3.     Interpret C.J.’s VS and relate these to the pathophysiology.3.    Explain the rationale for C.J.’s other presenting signs and symptoms.A decision is made to transport C.J. by ambulance to the local emergency department (ED). After evaluating C.J., the ED physician writes the following orders.  4.    Review each order. Mark with an “A” if the order is appropriate; mark with an “I” if inappropriate. For each order, you mark as I, explain why it is inappropriate, and correct the order. a.    _____ 1000 mL lactated Ringer’s IV statb.    _____ 36 units NPH (Humulin N) and 20 units regular (Humulin R) insulin SQ           nowc.    _____ CBC with differential; CMP; blood cultures x2 sites, clean catch urine for              UA and C & S; stool for ova and parasites, Clostridium difficile toxin, and              C & S; serum lactate, ketone, and osmolality; ABG’s on room aird.    _____ 1800 calorie, carbohydrate-controlled diete.    _____ Bedrestf.     _____ Acetaminophen (Tylenol) 650 mg PO q 4 h prng.    _____ Furosemide (Lasix) 60 mg IV push nowh.    _____ Urinary output q hi.     _____ VS q shiftQuestion: What additional interventions that need to be performed for C.J. and the rationale for the use of each. Thanks.  All orders have been corrected and initiated. C.J. receives fluid resuscitation and sliding-scale insulin drip via infusion pump. After several hours, her latest lab findings are as shown below. 2.Physician orders a change in the insulin drip infusion, decreasing it from 6 units to 4 units per hour. The label on the bag infusing reads, “100 units regular (Humulin R) insulin in 250 mL of normal saline.” At how many mL per hour will you set the infusion pump? 3.What is the rationale behind using an infusion pump for the insulin drip? Health Science Science Nursing Share QuestionEmailCopy link Comments (0)