Emergency Nursing Care in a Patient With a Serum Blood Glucose of 2394 mg/dL: A Case Review

Background

Diabetic ketoacidosis is a medical emergency arising from insufficient insulin supply in diabetes and is commonly triggered by infection. Management for diabetic ketoacidosis is well documented, which involves the administration of short-acting insulin, fluids, and electrolyte correction, with some studies describing a probable relationship between diabetic ketoacidosis and coronavirus disease 2019, resulting in extreme hyperglycemia.

Patient Presentation

This case review details the emergency nursing management of a 34-year-old female who presented in metabolic extremis from probable diabetic ketoacidosis. Serum blood analysis results revealed a blood glucose of 2394 mg/dL, a ketone level of 45.32 mg/dL, a potassium level of 6.1 mmol/L, unmeasurable hypothermia, coronavirus disease 2019 positivity, and progressive torsades de pointes. Management strategies focused on airway management, suitable tonicity and osmolarity correction, and rectification of electrolyte derangements.

Conclusion

The patient was transferred to a tertiary care hospital and discharged home with no physiological deficits. This case review aimed to inform the management of extreme hyperglycemia in diabetic ketoacidosis.