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J.S. is a 22-year-old insulin-dependent diabetic. For the past week, she has been struggling with an

upper respiratory infection which has become noticeably worse over the past 48 hours. Not feeling well enough to drive, she calls a friend to take her to the emergency room. When her friend arrives to take J.S. to the hospital, she finds her unconscious. While waiting for an ambulance, her friend notices J.S.'s breathing to be labored and deep.

J.S. is transported to the hospital where medical personnel begin treatment, draw blood for lab tests, and start an IV. A few minutes later, a laboratory technician calls to report a critical blood glucose level. Below are the labs:   

Na 124 meq/L

K   3.0 meq/L

 Glu 622 mg/dL

Serum pH 6.9

Ketones 3+ (urine)

1.  What is the likely cause of J.S. symptoms?

2.  Explain the pathophysiology of what is happening at the cellular level. Use the symptoms and assessment findings to support your explanation. 

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