The patient has been admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNKS). Her blood glucose level is very high (880 mg/dL on admission)
The physician believes that her condition is to the result of large amounts of glucose solutions administered intravenously during kidney dialysis. The nurse would anticipate that the patient would ex-hibit: 1. a fruity breath and high level of ketones in her urine.
2. severe dehydration and hypernatremia caused by the hyperglycemia.
3. exactly the same symptoms and signs as diabetic ketoacidosis.
4. Kussmaul's respirations, nausea, and vomiting.
2
IV solutions containing glucose will bypass the digestive system, so there is no trigger for the pancreas to release insulin, but there is just enough insulin to prevent the breakdown of fatty acids and the formation of ketones.
PTS: 1 DIF: Cognitive Level: Application REF: 1008
OBJ: 9 TOP: Hyperglycemic Hyperosmolar Nonketotic Syndrome
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
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