Table HYPERGLYCEMIC-HYPEROSMOLAR STATE.docx

5 diagnosis in addition to the conditions listed in

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5 Diagnosis In addition to the conditions listed in the differential diagnosis, any condition that can cause altered mental status should be considered, including the following: Central nervous system infection, Hypoglycemia, Hyponatremia, Severe dehydration, Uremia, Hyperammonemia, Intoxication, Sepsis, Change in mental status or level of consciousness, Postictal state, Arrhythmia, Hypotension. 6 Treatments The main goals in the treatment of hyperosmolar hyperglycemic state (HHS) are as follows: To vigorously rehydrate the patient while maintaining electrolyte homeostasis, To correct hyperglycemia, To treat underlying diseases, To monitor and assist cardiovascular, pulmonary, renal, and central nervous system (CNS) function. 7 Nursing Considerations Hydrate, decrease blood glucose, monitor potassium levels and for cerebral edema, correct acid-base imbalance (similar to the treatment of DKA). However, hydration will help just as well as insulin due to the severe hydration experienced in HHNS. The fluids will help hydrate the cell which will decrease glucose levels and help with electrolyte balance. 8 Patient Teaching Check a blood sugar level regularly. Take an insulin or diabetes medicine as directed. Prepare for sick days (Check a blood sugar more often than usual, Check for ketones, take an insulin or diabetes medicine as directed, Continue your normal meal plan if you can). Get help from others if patients are older and live alone.
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HYPERGLYCEMIC-HYPEROSMOLAR STATE Alexander Birukoff
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