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Hyperglycemia hyperosmolar nonketotic syndrome - Coggle Diagram
Hyperglycemia hyperosmolar nonketotic syndrome
Definition
It is a dangerous condition resulting from extremely high blood glucose, usually occurs on people with type 2 diabetes.
Causes
Infectious diseases like pneumonia or UTI
Poor management of glucose levels (diet and medication)
Taking glucocorticoids medication
Taking diuretics
Clinical manifestations
Tachycardia
Hyperglycemia
Polyuria
Polydipsia
Nausea and vomiting
Stomach aches
Confusion
Slurred speech
Weaknesses on one side of the body.
Pathophysiology
Elevated levels of counter regulatory hormones ( glucagon, catecholamines, cortisol and growth hormone)
They initiate HHS by stimulating hepatic glucose production through glycogenolysis
And glucogenesis, leading to hyperglycaemia, intracellular depletion of water and subsequent osmotic diuresis.
Diagnostic tests
Fasting blood sugar test
Random blood sugarsugar test
Oral glucose tolerance test
Glycated hemoglobin (A1C) test
Risk factors
Seizures.
Coma.
Swelling of the brain.
Organ failure.
Death.
Pharmacological management
Intravenous fluids (normal saline 0,9%)
Insulin therapy
Repletion of electrolytes (especially potassium)
Antibiotics (if vomiting and nausea are present)
Nursing intervention
Monitor fluid balance, to avoid fluid overload or deficit. As the patient is being put on iv fluids.
Assess precipitating factors such as other illnesses, new-onset diabetes, or poor compliance with treatment regimen.
Assess skin turgor, mucous membranes, and thirst.
Monitor BP especially for orthostatic hypotension.
Monitor respirations, e.g., acetone breath, Kussmaul’s respirations
Monitor temperature.
Fever with flushed, dry skin may indicate dehydration.
Monitor heart rate.
Compensatory mechanism results in peripheral vasoconstriction with a weak, thready pulse that is easily obliterated.