Chief Complaint:8-year-old girl with excessive thirst, frequent urination, and w

Question

Chief Complaint:8-year-old girl with excessive thirst, frequent urination, and weight loss. The following measurements were recorded in the MD's office: Current height: 53 inches, weight 30.1 kg, BMI: 18 History: Cindy Mallon, an 8-year-old girl in previously good health, has noticed that, in the past month, she is increasingly thirsty. She gets up several times a night to urinate, and finds herself gulping down glassfulls of water. At the dinner table, she seems to be eating twice as much as she used to, yet she has lost 5 pounds in the past month. In the past three days, she has become nauseated, vomiting on three occasions, prompting a visit to her pediatrician. Questions: At the doctor's office, blood and urine samples are taken. The following lab results are no ted: blood glucose level 545 mg/dl blood pH level-7.23 (normal-50- 170 mg/d) (normal 7.35-7.45) urine tested positive for glucose and for acetone/ acetoacetate (i.e. ketone bodies) (normally urine is free of glucose and ketone bodies) 1. Why is her blood-glucose level elevated? 2. Why is her blood pH level decreased? 3. At the office, Cindy is breathing rapidly and taking deep breaths. What physiological purpose does this serve? 4. What suggestions could you offer Cindy's caregivers or parents to provide them with support as they care for their daughter at home? Discuss the potential complications for Cindy if she or her caregivers are not compliant with her medical regimen while at home. 5. Explore the literature and research and discuss the immediate and future nutritional needs for Cindy. What education regarding Cindy's nutritional needs can be provided to the parents or caregivers as they prepare totake herbome?

Explanation / Answer

1. The blood glucose is elevated as the patient is suffering from type 1 diabetes that has a juvenile onset characterised by ployphagia, polydipsea and polyurea.

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