Case #6- DKA

Mrs. S is a 28-year-old patient, with a 12-year history of type I diabetes mellitus. Her husband states that she has had a "bad cold" for several days. Yesterday she stayed in bed and slept all day. She was "too ill" to check her blood sugar, and since she was not really eating, she did not take her insulin. This morning, she was not able to stand up and vomited twice. A Gram stain of Mrs. S's blood contains gram-positive cocci in clusters. Her admission vital signs are: BP 90/60; HR 118 bpm (sinus tachycardia); RR 32/min; T 102.3 F; O2 sat via pulse oximetry 96%. Her serum glucose is 398 mg/dl, and she is positive for serum ketones. She is admitted with a diagnosis of DKA.

Her baseline ABGs on 2 L of oxygen are: pH ; PCO2 28; HCO3 14; PaO2 92; O2 sat...