Recently I cared for a patient admitted with a diagnosis of Diabetic Ketoacidosis (DKA) and a previous history of Diabetes Mellitus type 1. Upon endorsement the patient received 500ml of fluid, with no follow up labs, no insulin drip, vomiting, and noncompliant. The patient was belligerent and refused to allow me to do an accucheck. Because of “patient rights”, I could have left him to his own devices. Instead, implementing beneficence and nonmaleficence, I spoke softly, expressed concern, and listened. I found out he’s suffered with diabetes since a teenager and was sick of being sick. Finally, he allowed me to do the assessment and draw labs.
Later in the shift, the patient’s condition worsened. I unsuccessfully attempted to contact the physician on several occasions. There were no orders for fluid therapy, antiemetic or an insulin drip. The physician finally arrived to the unit and was updated on the patient’s condition. I requested orders to begin DKA