47 women present to the casualty complaining of fever and chills since last night associated with body pains


 47 women present to the casualty complaining of fever and chills since last night associated with body pains

complaints of 10 episodes of vomiting


5:30 AM this morning which was yellow in colour, non projectile non bilious non particulate

 5 days ago she developed the small bleb on the plantar surface of a left foot on which home remedies were practiced and got infected on the in the due course

she was diagnosed with type 2 diabetes mellitus 6 years ago she has been on oral hypoglycemics for 5yrs and started insulin therapy since 1 year, 20 units morning and 15 units at night

she under went colonoscopy 3 months ago and was diagnosed with internal hemorrhoids prescribe with medication for a month

no history of being diagnosed with hypertension, TB, epilepsy bronchial asthma and CVA


O/E 

PT- C/C/C 

temp- 104.2

BP 110/70

PR 86

SpO2- 99%at RA 

CVS S1 S2 heard

RS BAE present, NVBS heard

PA soft non tender

CNS- NAD.






INVESTIGATIONS.








PROVISIONAL DIAGNOSIS:-


Diabetic ketoacidosis (secondary to infection) with known case of diabetes with known case of left lower limb cellulitis with known case of internal hemorrhoids.

TREATMENT:-

IVF NS 3L FOR 3HRS @150ML/HR.

INJ PAN 40MG IV/OD.

IVF 5%DEXTROSE 50-100ML/HR.

INJ OPTINEURON 1AMP IN 100ML NS/IV/OD OVER 30MINUTES.

INJ HAI 0.1IU/IV/KG WEIGHT IV BOLUS.

INJ NEOMOL 1g/IV/SOS.

INJ ZOFER 4MG/IV/TID.

STRICT BP,PR,TEMP MONITORING.

GRBS MONITORING HOURLY

STRICT LOWER LIMB ELEVATION








 



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