Vomiting will likely recur. A sudden onset or worsening of Wernicke's encephalopathy following glucose administration may be observed in thiamine deficient patients. 500 mg Use dextrose solutions to potentially stop fat breakdown. Continue hydration until able to tolerate PO fluids and little or no urine ketones. Use strict aseptic technique and utmost caution when caring for a patient s central line.
Sepsis threatens mom and baby.
Consider a trial hydration with Myer's Cocktail to increase nutritional levels. Check urine ketones at least q 8hrs. Review medication history and patient response and give antiemetics or other medications as needed. Refer for nutritional consult. Encourage a liver sparing diet as tolerated.