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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.
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