A patient has been admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS).The blood glucose level is very high (880 mg/dL)on admission.The physician believes that the condition is the result of large amounts of glucose solutions administered intravenously (IV)during renal dialysis.What should the nurse anticipate that the patient would exhibit?

Question

Quizplus · Accepted Answer

HHNS is a severe hyperglycemic condition that occurs primarily in patients with type 2 diabetes in response to a stressor such as infection or illness. Unlike diabetic ketoacidosis (DKA), there is no significant ketosis or acidosis present in HHNS. The major clinical features of HHNS are extreme dehydration, hypernatremia, and altered mental status. Treatment includes aggressive fluid replacement and correction of electrolyte imbalances. The high blood glucose levels in HHNS can be caused by increased production (as in DKA) or decreased utilization of glucose (as in HHNS). In this case, the patient's HHNS is believed to be caused by large amounts of glucose solutions administered during renal dialysis, leading to severe dehydration and hypernatremia. Fruity breath and high ketones in the urine are classic signs of DKA, not HHNS. Kussmaul respirations, nausea, and vomiting are also signs of DKA, not HHNS.

A Patient Has Been Admitted with Hyperglycemic Hyperosmolar Nonketotic Syndrome