HNNS

Etiology

Infections

Co-morbidities

(MI, heart


failure, stroke, pneumonia, kidney


disease)

Drugs

Undiagnosed DMII

Pathophysiology

DMII Insulin Resistance

Hyperglycemia

Hyperosmolarity

Dehydration

Some insulin is effective

Prevents lipolysis

DKA ⛔

Prolongs progress

Less likely to report to care

Diagnostics

Serum Glucose 33.3+

pH 7.3+

Treatment

DKA protocol

Insulin difference

Only used to treat hyperglycemia at a slow-infusion

May not be needed

Rehydration usually resolves hyperosmality

Osmolarity 320

Low Bicarb >15

Ketones : ⛔