Directions
The client is a 23-year-old African American male with type-1 diabetes who has not been taking his insulin as prescribed or adhering to a diabetic diet. The client presented to the emergency department with complaints of lethargy, abdominal pain, nausea, and malaise.
Vital signs:
- Temperature: 98.6 F
- Pulse: 110 beats/minute
- Respirations: 32 breaths/minute
- Blood pressure: 90/60 mm Hg
- Oxygen saturation: 96% on room air
Laboratory results:
- Serum glucose: 400 mg/dL (on arrival at the emergency department)
- Serum sodium (Na+): 125 mEq/L
- Serum potassium (K+): 6.5 mEq/L
- Serum chloride (Cl): 120 mEq/L
- Blood urea nitrogen (BUN): 39 mg/dl
- Serum creatinine (Cr): 1.7 mg/dl
- Urinalysis – positive for ketones
Arterial blood gas (ABG) results:
- pH: 7.30
- PaCO2: 33 mm Hg
- PaO2: 95 mm Hg
- HCO3: 19 mEq/L
The client is admitted to the intensive care unit, and you are the nurse assigned to the client. Reply to the following questions:
- Based on an interpretation of the ABG results, what acid-base imbalance is occurring?
- What nursing assessment findings are expected?
- Describe strategies for safe, effective multidimensional nursing care of the client. Include rationale to support the strategies identified.