You are admitting a patient with diabetic ketoacidosis. She has a history of Type I diabetes. She has told you that she doesn't know why this happened because she's been taking really good care of herself and her blood sugars have been "really really good." Which of the following assessment data leads you to question this statement?

 

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Correct

- Hemoglobin A1C 13%

- Fingerstick blood sugar 492

- Total Cholesterol 321

- Fruity breath

Rationale

Hemoglobin A1C of 13% indicates that over the last 3 months the patient has been averaging a blood sugar of 326 mg/dL. A current blood sugar of 492 is concerning, but it is more indicative of the current issue and not necessarily reflective of this patient's overall control over their blood sugars recently. The cholesterol level is high, but not near as concerningly high as the Hemoglobing A1C. Fruity breath would be consistent with her clinical picture and not surprising.

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Question ID - 368407

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