Collapsing at school

Case Study

Miss Matthews is a 17-year-old female who is brought to the emergency department after collapsing at school. She is currently alert and oriented x4, but pale and weak. A blood glucose performed by the paramedics read Max or high on the meter.

Upon further questioning, the parents report that their daughter has been weak a lot lately. Miss Matthews reports but she’s always hot and exhausted. She reports a 10-pound weight loss over the last 2 months despite eating all the time and agrees that she has been thirsty and peeing a lot.  The nurse notes Kussmaul respirations and fruity breath.  Vitals are 99.2 oral, bp 115/70, hr 109, 02 96 on RA (room air), RR (respiration rate) 26. Abdominal pain a 5/10.  Some nausea but no emesis.

A serum glucose revealed that Miss Matthews’ blood glucose is 523 mg/dL, and her urine was positive for ketones.

The provider steps into the room and asks you to update them on Miss Matthews’ condition.