PCCN Endocrine Study Guide

HHS Treatment Insulin management CORRECT ANSWER May require less insulin than in DKA May start with insulin bolus Regular insulin 0.1 U/kg/hr (or algorithm) Goal: decrease glucose slowly, not more than 50-100 mg/dL per hour Maintain insulin drip for 1-2 hours while starting SQ to prevent DKA relapse DKA Treatment Fluid Resuscitation CORRECT ANSWER Calculate fluid deficit (50-100 mL/kg) ~ 5-6 L Administer front loaded (1-3 L in hr 1) with taper to maintenance NS or LR (iso), add Dextrose when CBG 250 (lower risk for hypoglycemia), then 1/2NS or PO water for cellular resuscitation Serum Osmolality Serum Osmo calculations CORRECT ANSWER 275 - 295 Calculation (^ Glucose): 2Na + Glucose/18 + BUN/2.8 Calculation (Glucose WNL): ~ 2Na Isotonic IVFs Role in fluid dynamics CORRECT ANSWER NS LR Plasmalyte