Chapter 6, Problem 32R

Diabetes Insipidus management

A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, note that her skin in warm and flushed and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink. You get more information from A.M. and learn She had some readings on her glucometer which were reading ‘high’ She vomits almost every time she takes in fluid She hasn’t voided for a day but voided a great deal the day before She’s been sleeping long hours and finally woke up this morning and…

Insulin resistance described in pathophysology related to type 2 diabetes