AKA Case Study Summary

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PATHOPHYSIOLOGY:
The patient in the case study possible medical condition is Alcoholic ketoacidosis (AKA), with underlying sepsis, which has caused septic shock. AKA is an acute metabolic acidosis, which results from the metabolism of alcohol when the body has little or no glucose, this causes a build-up of ketones in the blood. Ketone, an acid that forms when the body has to break down fat for energy (Heller, 2013). AKA in most patients will present after a period of heavy drinking, and show as physical presentations of nausea, vomiting, and abdominal pain in a majority of patients. Other presentations include; dyspnoea, dizziness, muscle pain, diarrhoea, syncope, and seizure (Ansstas, 2014). During a physical examination the patient will …show more content…
This means when the patient is under the conditions of starvation and the glucose and glycogen stores are depleted the liver increased the production of the ketones from fatty acids, this allows for the supply of metabolic fuel (Ansstas, 2014). When the body metabolises the ethanol it creates an elevated NADH/NAD ratio, this impairs the hepatic gluconeogenesis that is metabolised from lactate, glycerol and amino acids, this can result in hypoglycaemia in acute alcohol intoxication (McGuire, Cruickshank & Munro, …show more content…
Because the patient has complained of nausea and started to vomit there is an indication of an antiemetic. A single dose of IM ondansetron at 4mg would be given to the patient (see figure 3 & 4)(QAS, 2011), which has been proven to be an effective treatment via IM routes (Salvucci, Squire, Burdick, Luoto, Brazzel, & Vaezazizi, 2011). At this time the primary paramedic would give the patient a primary dose of fentanyl of 120mcg (0.4ml) intra-nasal (Panagiotou, & Mystakidou, 2010), which can be repeated in five minutes if required up to a 60mcg (0.2ml) dose (see figure 5 and 6)(ACT Ambulance Service [ACTAS], 2014). This pain medication may help with the patient’s respiratory rate due to the decrease in pain and through
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