Diabetes Type I
Meet the Client: Lara Fielding
Lara Fielding, a 20-year-old college student, comes to the student health center with a 4-day history of flu-like symptoms. She reports feeling increasing fatigue, thirst, and nausea over the last 24 hours. Further assessment and lab work indicate that Lara is experiencing diabetic ketoacidosis (DKA). She is transferred to an acute care facility for treatment.
1Assessment
The nurse notes that Lara's breath has a fruity odor, and she is exhibiting Kussmaul respirations.
1. What is the mechanism that results in Kussmaul respirations?
A. Correct To compensate for metabolic acidosis, the respirations are deep and rapid.
To compensate for the ketoacidosis (metabolic acidosis), the lungs attempt to remove CO2 through a pattern of deep, rapid respirations referred to as Kussmaul respirations.
B. To overcome respiratory acidosis, the respirations are fast and shallow.
Diabetic ketoacidosis is not respiratory acidosis.
C. Injury to the brain's respiratory center results in periods of apnea.
This may occur late in untreated DKA, but it is not the mechanism producing Kussmaul respirations.
D. Hypoxemia causes labored, gasping, and irregular respirations.
This is not the mechanism producing Kussmaul respirations.
3.
Lab work reveals that Lara's blood glucose level is 370 mg/dl, plasma bicarbonate is 8 mEq/L, potassium is 5.2 mEq/L, and she has elevated ketones in her urine. Goals of treatment in DKA include correcting fluid imbalance and restoring normal pH, electrolytes, and glucose.