Case Scenario:
14 year old admitted to ward by one of the pediatrician to manage mild DKA (Diabetic Ketoacidosis).
Background:
Type 1 Diabetes
Positive thyroid antibodies with normal thyroid function
Labile blood sugar
Complain of nausea, thirsty, not eating, only had few sips of water and LLQ abdo pain- sharp and "pins and needles"
Patient is very alert and orientated, but looking very tired or no energy, always in bed. ketones in urine-ascribed to fasting
Questions: Making a clinical reasoning cycle
Q1: What are the top 3 problem using the information above that may related to DKA?
Q2: What are the goals? (TOP 3 problems)
Q3: What are the interventions and rationale (from both Q1 and Q2)?
Q4: As a nurse, what are things we need to be aware and why are we implementing strategies to prevent DKA? Also, what are the factors that contributed a child to have DKA?
Q5: What are the things that we need to know about DKA?
Q6: If left untreated or did nothing, what will happen to patient or potential complications?
Q7: If we're looking after teenagers with DKA again, what could we do differently?