Case Study Assignment Question & Answer Guide (With Explanation)

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Original Question

DKA Case Study Assignment Patient Name: Maria Torres Age: 23 Chief Complaint: “I feel really sick, nauseous, and I’ve been vomiting all morning.” History: Type 1 Diabetes since age 14; recent flu-like illness; skipped insulin last night due to nausea and lack of appetite. Presentation: Confused, weak, fruity-smelling breath, rapid breathing Vital Signs on Arrival: • Temp: 37.2°C • HR: 124 bpm • BP: 88/54 mmHg • RR: 30/min (deep and rapid) • SpOâ‚‚: 97% on room air Labs: • Glucose: 465 mg/dL • Serum ketones: positive • Arterial pH: 7.08 • HCO₃⁻: 9 mEq/L • Anion gap: 24 • Potassium: 5.8 mEq/L • Urinalysis: Large ketones, glucose ++ Instruction: Answer the following question based on the information presented in the case study indicated above. 1. What signs and symptoms indicate DKA in this patient? 2. What is the significance of her lab values (pH, glucose, potassium, anion gap)? 3. How does her history contribute to the current condition? 4. What are your top 3 immediate nursing priorities for Maria? 5. What orders do you expect from the provider? 6. Which IV fluid should be started and why? 7. Why is potassium closely monitored, even though it’s elevated? 8. When and how would insulin therapy be initiated? 9. What are the risks of starting insulin too quickly? 10. What signs would indicate that the patient is improving or worsening? 11. What would you teach Maria about managing diabetes during illness (“sick day rules”)? 12. How can she prevent future episodes of DKA?

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