Case Study
Mr. Gutteman, a 70-year-old male, was brought into the ER. He had been sick
several days with the flu, and was found confused and barely conscious by his
daughter.
Mr. Gutteman is breathing rapidly and has a fever of 39°C (102°F). His skin is dry
and flaccid, his mucous membranes are dry, and his eyes are sunken. The
physician ordered:
• / /IV (intravenous) fluid and electrolyte replacement
• / /Blood and urine tests for presence of glucose and ketones
• / /Strict I&O [careful measurement of fluid intake (e.g., IV, drinking) and output
(e.g., urine)]
Give some thought to Mr. Gutteman’s signs and symptoms and discuss your
assessment of his injuries. Address the following questions in your assessment:
1. / /You would expect high levels of blood glucose and the presence of glucose
and ketones in Mr. Gutteman’s urine if:
/ / / / / a. / /His pancreas is secreting too much insulin
/ / / / / b. / /His liver is secreting too little insulin
