confusion

Question 1

what investigations would you do on an acutely confused patient

Answer 1

capillary glucose

Question 2

causes of acute confusion

Answer 2

UTI
Subdural haemorrhage
aspiration pneumonia
uncontrolled diabetes

Question 3

risk factor of HHS

Answer 3

undiagnosed type 2 diabetes

Question 4

features of HHS

Answer 4

about a week
marked dehydration
glucose above 35mM
acidosis is absent

Question 5

what Ix are important in HHS

Answer 5

ABG - good for monitoring progress

Question 6

what Ix are important in HHS

Answer 6

ABG - good for monitoring progress

Question 7

treatment for HHS

Answer 7

8-10 litre of fluid hydration

prophylatic heparin for prevention of DVT
nasogastric tube - confused and remains unconscious, reduce risk of aspiration

central venous access - accurate fluid balance and maintenance of central filling pressure

urinary catheter - monitor urine output

broad spectrum ABx

Question 8

outpatient care with HHS

Answer 8

dietician input
diabetic specialist nurse contact
BP monitoring
retinal screening
assessment of blood lipids
annual foot check and routine foot care