CC – Confusion – reported by patient’smother. Diagnosis – DKA – DKA,substance use disorder, diabetesinsipidus, dehydration, DM Type 1 Tests- BMP, UA,Drug tox, arterial blood gas, 12lead ECG, beta-hydroxybutyric acid (BOH) Problem Statement: ( Demographic description – chief complaint – Hx and PE key findings – risk factors ) Melissa Stewart is a 12 year old child brought in by her mother with complaint of confusion since morning. Melissa is obtunded and only responsive to verbal commands. Her mother states that she recently has been losing weight and eating more and experiencing polyuria and polydipsia as well as blurred vision. Today she istachypneic, tachycardia, lethargic and confused with continued blurry vision. PE shows decreased skin tugor, delayed capillary refill and fruity breath. Risk factors include a family history of a “sugar problem”. CC: Melissa Stewart is a 12 year old child brought in by her mother with complaint of confusion since morning.. HPI: . Melissa is obtunded and only responsive to verbal commands. Her mother states that she recently has been losing weight and eating more and experiencing polyuria and polydipsia as well as blurred vision. Today she istachypneic, tachycardia, lethargic and confused with continued blurry vision. Meds: None PMH: noncontributory FH: Paternal grandfather diabetes. SH: Motherstates child does notsmoke, drink alcohol, or take recreational drugs.