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HYPERGLYCAEMIC HYPEROSMOLAR NONKETOTIC SYNDROME (Symptoms (Excessive…

- - - - Assess precipitating factors such as other illnesses, new-onset diabetes, or poor compliance with treatment regimen.
      - Assess skin turgor, mucous membranes, and thirst.
      - Monitor hourly intake and output.
      - Monitor BP especially for orthostatic hypotension.
      - Monitor respirations, e.g., acetone breath, Kussmaul’s respirations.
      - Assess neurological status every two (2) hours.
      - Monitor laboratory studies:
      - Insert indwelling urinary catheter as indicated.
      - Administer fluid as indicated: Isotonic solution (0.9% NaCl).
    - - Client will remain normovolemic as evidenced by urinary output greater than 30 ml/hr, normal skin turgor, good capillary refill, normal blood pressure, palpable peripheral pulses, and blood glucose levels between4-6 mmol/L.
    - - At risk for experiencing vascular, cellular, or intracellular dehydration.
    - - Normal input and output balance
  - - - Patient t will identify interventions to prevent reduce risk of infection.
    - - Assess for signs of infection and inflammation.
      - Observe client’s feet for ulcers, infected toenails, or other medical problems.
      - Observe aseptic technique during IV insertion and medication administration.
      - Encourage adequate oral fluid intake (2-3 liters a day unless contraindicated).
      - Administer antibiotics as indicated.
    - - At increased risk for being invaded by pathogenic organisms.
    - - Patient should be infection free
  - - - Absence or deficiency of cognitive information related to specific topic.
    - - Patient will verbalize understanding of the disease condition and potential complication.
      - Patient will correctly perform necessary procedures and explain rationale on each action.
      - Client will demonstrate lifestyle changes and participate in treatment regimen.
    - - Establish rapport and trust.
      - Demonstrate proper blood glucose testing using the glucometer. Instruct client to check the urine for ketones once blood glucose reaches 5.5 mmol/L or higher.
      - Teach client that polyuria, polydipsia, and polyphagia are signs of hyperglycemia which requires increased dosage of insulin.
    - - Have a question and answer session to weigh patients understanding