Betty Cooper, 25-y/o-female, is admitted to the emergency department with decreasing level of
consciousness. She is 98lbs and stands at 5ft. She has a history of diabetes mellitus since she was
9 years of age. A physical assessment and laboratory data reveal the following:
➢ Dry skin, poor turgor > Serum glucose = 504mg/dl
➢ RR = 40cpm, rapid and deep & labored > Serum Na = 130 mEq/L
➢ HR = 118bpm, weak pulse > Serum K = 5 mEq/L
➢ Temp = 98°F > Serum Cl = 108 mEq/L
➢ BP = 110/70 mmHg > BUN = 74.68 mg/dL
➢ ABG: pH = 7.15; HCO3; 13mEq/L; pCO2 = 35 mEq/L
1. Calculate Betty’s serum osmolality.
2. What type of diabetes mellitus does Betty possibly have? Why?
3. Which complication of diabetes mellitus does Xia possibly have, diabetic ketoacidosis or
hyperglycemic hyperosmolar state? Why?
4. What is the 1st priority nursing management and medical management? Why?
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