Chronic Illness Trajectory Case Study

The Chronic Illness Trajectory Assumptions applied to Patient Care of Diabetes Mellitus in a Hospital Setting The client is a 24-year-old African American male. The patient was diagnosed and treated for Diabetic Ketoacidosis (DKA), urinary track infection (UTI), and dehydration. DKA is a condition that occurs when glucose is not able to be used properly by the body because of a lack of insulin. The patient has a past medical history of type one diabetes mellitus, asthma, and depression. The seven assumptions of The Chromic Illness Trajectory Framework will be addressed to outline the patient’s plan of care and the course chronic illness influences his health.

The patient presented to the hospital with nausea, vomiting, tachycardia, hypotension, altered level of consciousness, abdominal pain, and a blood glucose level of 710. Type one diabetes mellitus occurs when the beta cells of the pancreas do not produce insulin. Insulin allows the glucose to enter the cells to provide fuel for the tissues. Without glucose the body will use ketones for energy and if untreated develop DKA (Jerreat, 2010). The patient was treated with insulin, intravenous fluids, electrolytes, and antibiotics. With treatment the initial

Intravenous and sub-cutaneous insulin is administered to the patient until blood glucose is controlled and urine ketones are negative or trace. When the patient was able to eat food, intravenous and sub-cutaneous insulin was continued simultaneously for two hours to insure adequate plasma insulin levels and to prevent hypoglycemia (Del Carmen Garcia-Pascual, 2012). His potassium level was monitored every two hours and potassium was supplemented to treat the patient’s hyperkalemia. Insulin treatment, to lower blood glucose levels, caused the patient to develop hypokalemia. Hypokalemia can cause serious cardiac arrhythmias (Del Carmen Garcia-Pascual,