Emergency Department · 0742
Amara, 24 — “I've been so thirsty I can't stop drinking water.”
Amara is a 24-year-old woman brought to the emergency department by her roommate. She has type 1 diabetes and tells you she ran out of insulin four days ago while waiting for a refill.
For the past two days she has been vomiting and unable to keep fluids down. Her roommate says she has been “breathing funny” since last night.
On arrival:
- Temperature
- 37.4 °C
- Heart rate
- 124/min
- Respirations
- 32/min, deep and regular
- Blood pressure
- 96/58 mm Hg
- SpO₂
- 98% on room air
- Blood glucose
- 486 mg/dL
Her mucous membranes are dry, her skin turgor is poor, and there is a faint fruity odor to her breath. She is drowsy but answers questions.
Which action should the nurse take first?