HHS Flashcards
How does HHS differ from DKA?
- Ketone levels are low/absent
- Blood glucose levels are much higher
- D/T residual insulin secretion
BLOOD GLUCOSE levels may EXCEED _____ mg/dL
600
BLOOD OSMOLARITY may EXCEED _____ mOsm/L
320
The ONSET of HHS is __________.
Gradual
Precipitating FACTORS of HHS include infection, stress and ____________.
Poor fluid intake
HHS usually OCCURS in patients over the AGE of ____ with TYPE ____ DIABETES.
60 years of age 👵🏽
Type 2 diabetes
INSULIN SECRETION in HHS just enough to PREVENT __________ but NOT ENOUGH to prevent __________.
- Enough to prevent Ketosis
2. NOT enough to prevent Hyperglycemia
How will HHS MANIFEST in a patient?
Altered CNS function
What are FIVE (5) CAUSES of HHS?
- MI 💔
- Sepsis 💩
- Pancreatitis
- Stroke
- Medications 💊
What are FIVE (5) MEDICATIONS that can CAUSE HHS?
- Glucocorticoids
- Diuretics
- Phenytoin (Dilantin)
- Propranolol (Inderal)
- Calcium Channel Blockers
What are some (3) COMPLICATIONS of the CNS seen in patients wit HHS?
- Seizures
- Myoclonic jerking
- Reversible paralysis
COMA occurs in an HHS pt with OSMOLARITY greater than ____.
350
What is the FIRST PRIORITY of the nurse treating a pt for HHS?
Replace blood loss
The expected OUTCOME of FLUID THERAPY for an HHS pt is to restore blood glucose within ____ to ____ hours.
36-72 hours
In SHOCK or SEVERE HYPOTENSION give __________ saline.
Normal saline
Half of the estimated WATER DEFICIT is REPLACED in the first ____ hours and the REMAINDER is given over the next ____ hours.
1/2 within first 12 hours
Remainder 36 hours
What HEALTH ISSUES (3) indicate that the pt being treated for HHS needs to be MONITORED closely?
- CHF
- Kidney Disease
- Acute Kidney Injury
What is the BEST evidence that FLUID MANAGEMENT is SATISFACTORY?
Slow but steady improvement in CSN function
When providing FLUID THERAPY to a pt with HHS, the nurse notices NO SIGNIFICANT IMPROVEMENT in LOC when performing her hourly assessment. What would be the best intervention?
Increase rate of fluid replacement
What do signs of REGRESSION of LOC in a pt AFTER initial IMPROVEMENT indicate?
Too rapid of fluid replacement
True or False insulin must be administered prior to fluid replacement.
FALSE, insulin is administered AFTER adequate fluids have been replaced
What FIVE (5) factors DETERMINE the RATE of INFUSION for fluid therapy in HHS pts?
- Body weight
- UOP
- Kidney Function
- Pulmonary congestion
- Jugular Distention
