A nurse working in the pediatric ICU is admitting a 16-year-old patient with type 1 diabetes mellitus who presents with complaints of elevated blood glucose, hot and dry skin, and polyuria (increased urination). Urinalysis reveals glucosuria (sugar in the urine) and ketonuria (ketones in the urine). Upon physical assessment of the patient, the nurse notes that the eyes appear sunken and the patient has poor skin turgor. The nurse recognizes the patient will likely be treated for which of the following? 

Explanation

•Patients with type 1 diabetes mellitus may experience diabetic ketoacidosis (DKA) when there is insufficient insulin to transport glucose into cells for energy.

•This condition can lead to fluid volume depletion (dehydration) due to polyuria (excess urination) as the kidneys attempt to filter glucose from the bloodstream.

•Cells are unable to get glucose for energy production due to lack of insulin. This causes the body to break down fat and protein for energy. The by-products of this process are ketones which make the blood acidic.

•Patients with type 2 diabetes mellitus still produce some insulin in the pancreas so DKA does not occur in these patients.

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