Question

An older adult client with type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client’s daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority?

Answer 1

Answer:

The options:

A) Administration of antihypertensive medications

B) Administering sodium bicarbonate intravenously

C) Reversing acidosis by administering insulin

D) Fluid and electrolyte replacement

The CORRECT ANSWER IS D)

D) Fluid and electrolyte replacement

Explanation:

A) Administration of antihypertensive medications❌

Antihypertensive drugs are not stipulated, as hypotension on a usual basis go along with HHS as a result of dehydration.

B) Administering sodium bicarbonate intravenously❌

Sodium bicarbonate is not dispensed to clients with HHS, due to the fact that they have a regular plasma bicarbonate level.

C) Reversing acidosis by administering insulin❌

Insulin dispensation as a less significant path in the remedy or cure of HHS due to the fact that it is not necessary for reversal of acidosis, as the case may be in diabetic ketoacidosis (DKA).

D) Fluid and electrolyte replacement✔✔✔

The total perspective to HHS entails fluid renewal, rectifying of electrolyte imbalances, and insulin dispensation.

Answer 2

Answer:

The nurse should prioritize the patient's critical glucose level, and inform the doctor to get orders to reduce it.

Explanation:

This is the main course of action since untreated hyperglycemia can lead to renal failure, visual alterations/blindness, nerve/vascular damage, worsening of infection and intestinal issues such as diarrhea or constipation.