NSG 4100 EXAM 2
Hyperglycemic Hyperosmolar State (HHS) etiology
-Some insulin but not enough
-Stress can increase insulin demand
-Can be from infection
-Older adults with no history of diabetes can be at risk
Hyperglycemic Hyperosmolar State (HHS) s/s and complications
-polyphagia/ polyuria/ polydipsia
-dehydration
-tachy
-high glucose
-low bp
-neuro issue (confusion)
-No ketones, no acidosis
HHS teaching
-Thiazides and dialysis increase body resistance (hyperglycemia)
,HHS diagnosis
-BG 600-1200
-Osmolality >320
-No ketones
HHS treatment
-IV regular insulin asap
-fluids
HHS NI
-Assess GCS fast
-cardiac monitor
-fluids (normal for K+ to lower with fluid replacement)
-administer insulin
DKA etiology
-No insulin made
-missed dose of insulin or infection
, DKA s/s and complications
-ketones
-metabolic acidosis
-high glucose
-low bp
-polyuria
-kussmauls
-polyphagia
-polydipsia
-change in LOC
DKA teaching
-sick day rules
DKA diagnosis
-BG 300-800
-low bicarb 0-25
-low pH 6.8-7.3
-low pCO2 10-30
-ketones
Hyperglycemic Hyperosmolar State (HHS) etiology
-Some insulin but not enough
-Stress can increase insulin demand
-Can be from infection
-Older adults with no history of diabetes can be at risk
Hyperglycemic Hyperosmolar State (HHS) s/s and complications
-polyphagia/ polyuria/ polydipsia
-dehydration
-tachy
-high glucose
-low bp
-neuro issue (confusion)
-No ketones, no acidosis
HHS teaching
-Thiazides and dialysis increase body resistance (hyperglycemia)
,HHS diagnosis
-BG 600-1200
-Osmolality >320
-No ketones
HHS treatment
-IV regular insulin asap
-fluids
HHS NI
-Assess GCS fast
-cardiac monitor
-fluids (normal for K+ to lower with fluid replacement)
-administer insulin
DKA etiology
-No insulin made
-missed dose of insulin or infection
, DKA s/s and complications
-ketones
-metabolic acidosis
-high glucose
-low bp
-polyuria
-kussmauls
-polyphagia
-polydipsia
-change in LOC
DKA teaching
-sick day rules
DKA diagnosis
-BG 300-800
-low bicarb 0-25
-low pH 6.8-7.3
-low pCO2 10-30
-ketones
