70-years old male patient was submitted to ER: he was sick with flu for several

Question

70-years old male patient was submitted to ER: he was sick with flu for several days, confused, and barely in conscious found by neighbors, T = 39 C0 , rapidly breathing, dry and flaccid skin, dry mucous membranes, and with sunken eyes. The ER doctor order:

·        IV fluid and electrolyte replacement

·        Blood and urine tests for presence of glucose and ketones

·        Strict I & O

Questions:

1.   Why would you expect high-levels of blood glucose and presence of glucose and ketones in his urine?

2.   Patients blood and urine tests were negative for glucose and ketones. However, he is losing a large amount of water in urine, which was replaced by IV. Based on this new update, patient’s excessive fluid loss in his urine most likely indicates what?

3.   His diagnose is diabetes insipidus. He has been placed on diabetic diet. What would be your concern about this diet? Explain!!!

4.   Is this diabetes insipidus life threatening? Explain your answer!

Explanation / Answer

1. The patient presented in ER with severe dehydration and altered sensorium. These are clinical presentation of diabetes (as in diabetes there is polyuria or excessive urination which leads to dehydration and severe dehydration leads to altered sensorium ) and in diabetes blood sugar is raised plus there is presence of glucose and ketone in urine. So we expect high level of glucose in blood and presence of Ketone and glucose in patients urine.

2. Since patients blood and urine test was negative for glucose and ketones it indicates that this is not a case of diabetes mellitus rather it can be cause of diabetes insipidus.

3. Patient of diabetes insipidus complaints of excessive thirst and frequent urination so his diet must be such that it does not aggravate thirst and urination plus it must promote replenishment of lost body water. So he should

4. Yes, diabetes insipidus can be life threatening.

Patient with diabetes insipidus that is undiagnosed and untreated results in dramatic decline in the quality of life and there is a serious risk of dehydration, electrolytes imbalance in the blood such as potassium and salt which can be life threatening.

Sometime this disease can be mistaken for "compulsive drinking disorder" and then the patient withhold fluid intake (results in severe dehydration) which can then become dangerous and even life threatening.

Related Questions

Navigate

• Browse (All)
• Browse 7
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.