10-26-2007, 08:07 AM
A 53 year old woman presents to the emergency room with abdominal pain, nausea, vomiting, hypotensive, tachycardia and disoriented. A FSG check comes back as >500. You quickly get a urine sample and analyze it with a dipstick. It shows the following results:
Specific Gravity=1.005/pH=5.5/1+protein/4+glucose/+ketones/0 RBC,WBC, epithelials cells.
You promptly get IV access and draw the necessary blood studies. Your next step would be to:
a ) Give Normal saline bolus and run IV fluids wide open
b ) Give Normal saline and give 10 units of NPH and start an insulin drip at 0.1 units /kg /hr
c ) Give Normal saline and start on Diabeta 10 mg
d ) Give Normal saline , Wait for Lab result and give Insulin
Specific Gravity=1.005/pH=5.5/1+protein/4+glucose/+ketones/0 RBC,WBC, epithelials cells.
You promptly get IV access and draw the necessary blood studies. Your next step would be to:
a ) Give Normal saline bolus and run IV fluids wide open
b ) Give Normal saline and give 10 units of NPH and start an insulin drip at 0.1 units /kg /hr
c ) Give Normal saline and start on Diabeta 10 mg
d ) Give Normal saline , Wait for Lab result and give Insulin