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Hyperosmolar Hyperglycemic Syndrome - Coggle Diagram
Hyperosmolar Hyperglycemic Syndrome
Pathophysiology
Life-threatening syndrome that can occur in a patient with diabetes who is able to produce enough insulin to prevent DKA, but not enough to prevent sever hyperglycemia, osmotic diuresis, and extracellular fluid depletion
Common Causes
UTI
Pneumonia
Spesis
Any acute illness
Newly diagnosed Type 2 Diabetes
Main difference between HHS and DKA is that those with HHS usually have enough circulating insulin so the ketoacidosis does not occur
Lab Values
Blood glucose level greater then 600 mg/dL
Larked increase in serum osmolarity
Ketone bodies are absent or minimal in both blood and urine
Interprofessional Care
Immediate IV administration of insulin and either 0.9% or 0.45% NaCl
Requires large volumes of fluid replacement - should be done slowly and carefully
Monitor to avoid fluid overload during fluid replacement
When blood glucose levels fall to approximately 250 mg/dL, IV fluids containing dextrose are administered to prevent hypoglycemia
Assess vital signs, intake and output, tissue tumor, lab values, and cardiac monitoring
Nursing Management
Administer IV fluids
IV administration of short-acting insulin
Electrolyte replacement
Assessment of mental status
Recording intake and output
Central venous pressure monitoring
Assessment of blood glucose levels
Assessment of blood and urine for ketones
ECG monitoring
Assessment of cardiovascular and respiratory status
Signs and Symptoms
High glucose >600 mg/dL
Polyuria
Polydipsia
Dehydrated: dry mucous membranes
Fever
Fatigue
Mental Status Changes
Coma
Resources: MedSurg Textbook and Saunders Textbook