48 - HHS

Question 1

HYPEROSMOLAR

Answer 1

low H2O
high electrolytes

Question 2

Hyperosmolar Hyperglycemia Syndrome

Answer 2

pt w DM
-has enough insulin to prevent DKA
-not enough insulin to prevent severe hyper-glucose, osmotic diuresis, + ECF depletion

Question 3

precipitating factors of HHS

Answer 3

-UTI
-PNA
-sepsis
-acute illness
-newly diagnosed DM2

Question 4

hhs is often r/t

Answer 4

-impaired thirs senstn
-functnl inability to replace fluids
-hx of inadeq fluid intake
-incr mental dprssn
-cogntv impairment
-polyuria

Question 5

main diff bw DKA + HHS

Answer 5

HHS> has enough circultng insulin
-fewer s/s in early
-bld gluc > 600mg/dL
-ketonuria is absent/min

Question 6

bc of fewer s/s in early HHS…

Answer 6

unknown that its happening… glucose climb high before noticable
-hypo-K is not significant
>severe neuro s/s: somnolescence, coma, seizure, hemiparesis, aphasia (sim to stroke)

Question 7

tx

Answer 7

similar to DKA
immediate IV of 0.45-0.9 NaCl
-when gluc lvl is close to 250, then give IV dextrose to prevent hypo-gluc