The following 14 questions refer to the scenario for Lorelie…
The following 14 questions refer to the scenario for Lorelie Wonder Ms. Wonder is a 48-year-old woman with arthritis and hypothyroidism. She is prescribed corticosteroids, an antihypertensive, an anti-inflammatory, and a synthetic thyroid medication, which she takes on a daily basis. Ms. Wonder is unable to walk, uses a wheelchair, and has significant deformities of her hands, knees, and elbows. Her vital signs upon admission to the emergency room are: Vital Signs: Temp: 37.8C Pulse: 112 RR: 28 B/P: 85/40 The nurse notices a fruity aroma on Ms. Wonder’s breath, along with a breathing pattern that is deep and fast. On oral examination the nurse notes Ms. Wonder’s skin and mucous membranes are dry and warm. Ms. Wonder states she’s had an increase in hunger and thirst recently and also mentions she has to urinate a lot lately. Serum Electrolytes Urinalysis Na 130 mEq/L MACROSCOPIC Cl 110 mEq/L Color – Dark Amber Turbidity – Clear pH – 3.2 K 3.0 mEq/L Specific Gravity – 1.028 Glucose – Large Ketones – Positive BUN 42 mg/dl Protein – Negative Blood – Negative Bilirubin – Negative Creat. 0.8 mg/dl MICROSCOPIC CO2 18 mmol/L RBCS – Negative Bacteria – 50,000/ml Fat – None Ca 8.9 mg/dl WBCs – Negative Epithelial cells – None Casts – None Mag 2.0 mEq/L Crystals – None Leukocyte esterase – Negative Nitrite – Negative Phos 1.8 mg/dl Gl 532 mg/dl Albumin 3.7 g/dl Considering the above data, Ms. Wonder has developed:
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