(4)
Slow and labored respirations, air hunger.
(5)
Anorexia and nausea.
(6)
Tachycardia.
(7)
Hypotension.
(8)
Polydipsia (excessive thirst).
(9)
Large and frequent urine output (polyuria).
(10) Presence of sugar and acetone in the urine.
(11) High blood sugar level.
c. Pathophysiology.
(1) As mentioned above, when glucose cannot be utilized, fats and proteins
are broken down for energy. Their by-products (ketones) accumulate in the blood.
Ketone bodies are strong acids that can lower blood pH, producing metabolic acidosis
(ketoacidosis).
(2) Electrolyte disturbances occur as a result of polyuria, dehydration, and
the alteration in pH.
(3)
Hypothermia and a lack of pyrexial response (fever) to infection may
occur.
(4) Level of consciousness will begin to alter (probably due to diminished
brain perfusion of oxygen), resulting in coma and death if the condition is left untreated.
d. Nursing management.
(1) Administer insulin. (The physician will usually order administration of a
low dose of regular insulin intravenously.)
(2)
Draw blood for a glucose level.
(3)
Monitor vital signs and level of consciousness carefully.
(4)
Force fluids (usually IV).
(5)
Insert a retention catheter to monitor urine output.
(6)
Observe for respiratory changes.
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