What are the priority areas of concern for the individual in an advanced nursing role to consider in reviewing the expected diagnostic test results for an individual suffering from DKA, which may include changes to acid-balance, bicarbonate level, and electrolyte balances?

Prioritizing areas of concern is important for advanced nurses who are reviewing test results. Changes in bicarbonate levels, acid-base imbalances, and electrolyte equilibriums are the primary concerns. In DKA, the body’s insulin deficiency leads to a shift towards ketone body metabolism, which results in an increase in the production of ketoacids. The shift in metabolism results in a drop in pH in the blood, which leads to metabolic acidosis. As a result, the priority areas of concern in the diagnostic test results include monitoring the patient’s pH, bicarbonate level, and electrolyte levels.

DKA is usually treated with insulin administration, fluid replacement, and electrolyte replenishment. Insulin administration is essential to shift the body’s metabolism back to glucose metabolism, leading to a decrease in ketoacid production. To replenish fluids lost by excessive urination as well as to increase blood pressure, it is essential to perform fluid resuscitation. To correct electrolyte balances caused by fluid loss or insulin treatment, it is important to replace the electrolytes. Electrolyte deficiencies are the primary cause of DKA. These include hypokalemia (low potassium), hyponatremia (low sodium), and hypophosphatemia.

Summary: When reviewing diagnostic test results for DKA, it is important to prioritize the most critical areas, which are the acid-base, bicarbonate, and electrolyte levels. Individuals with DKA are usually treated by insulin, fluid replacement, and electrolyte replenishment.

The diabetic male, 45, who is married and African American, has two main needs: glucose control, and replacement of electrolytes. Plan of care: Insulin to regulate blood sugar, fluids for electrolyte and fluid balance and electrolyte replenishment as required. His cardiovascular health may need close monitoring, especially if hypotension is present. The care requirements for the widowed African American of 85 years may be complex due to his advanced age. In order to avoid hypoglycemia he might need a more conservative approach in fluid replacement or insulin administration. In addition, his stress from hospitalization and age may make it necessary to monitor him for any signs that indicate cognitive impairment. With the appropriate treatment, it is likely that both patients’ acid-base and electrolyte balances will improve over the course of 48 hours. The plan of treatment should still be reviewed to make sure that the patient’s needs are met.