A 21-year-old noncompliant female with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. Her blood glucose was high, as well as her urine glucose, urine ketones, and serum ketones. Her serum bicarbonate was < 12 mEq/L. Her respiration was exaggerated and his breath had an acetone odor. Her blood pressure was 90/60 and his pulse weak and rapid (120).
What is the cause of the dyspnea, hypotension, and tachycardia? I'll get you started... this is classic diabetic ketoacidosis (DKA), which is an anion gap metabolic acidosis. Initial treatment should focus on controlled rehydration and getting her sugar down. |
