Northland College
AP 2
The Case of the Noncompliant Female

A 21-year-old noncompliant female with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. Her blood glucose was high, as well as her urine glucose, urine ketones, and serum ketones. Her serum bicarbonate was < 12 mEq/L. Her respiration was exaggerated and his breath had an acetone odor. Her blood pressure was 90/60 and his pulse weak and rapid (120).

Type 1 diabetics have to take insulin injections.

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QUESTIONS
Answer the following questions about this case. You can list your sources with each question or you can indicate your sources in the space provided at the end of the questions. Remember to review the criteria used for grading the case studies as given on the CASE STUDIES INDEX page. Including too much in your responses is better than not enough.

**You will need to supply a minimum of 4-5 sentences supporting each of your answers.
 

   1. Define noncompliant.

2. Is this person experiencing ketoacidosis or insulin shock? Explain your answer.

3. Why is the serum bicarbonate low?

4. What is the acid-base status of this individual?

5. What is the cause of the dyspnea, hypotension, and tachycardia?

6. What type of treatment does this person need?

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