Chapter 8

The elevated fasting glucose level of 254 mg/dL indicates severe hyperglycemia, characteristic of diabetic ketoacidosis (DKA). The high white blood cell count of 15,000 mL suggests an infection, which commonly accompanies DKA, due to compromised immune function. The normal red blood cell count indicates the patient is not currently experiencing anemia, and the elevated sodium level of 156 mg/dL reflects dehydration, a common consequence of DKA. The presence of urine ketones further confirms the body’s breakdown of fats or proteins in the absence of insulin, contributing to the metabolic derangements seen in DKA.

The elevated white blood cell count of 15,000 mL suggests an inflammatory response and potential infection, which can exacerbate the patient’s condition and complicate management. Poor response by leukocytes may indicate impaired immune function, placing the patient at increased risk of sepsis and other serious complications. Nurses should closely monitor the patient for signs of infection and collaborate with the health care team to initiate appropriate antimicrobial therapy and supportive care.

Priority nursing interventions include initiating insulin therapy to correct hyperglycemia and acidosis, administering intravenous fluids to address dehydration and electrolyte imbalances, and monitoring the patient closely for signs of infection. Additionally, providing supportive care, such as pain management and emotional support, is crucial for optimizing patient outcomes. Continual assessment and reassessment of the patient’s condition are essential to guide timely interventions and promote recovery from DKA.