The nurse from a dialysis center calls a nurse in the emergency eepartment to report that a client with type 2 diabetes mellitus is on the way to the ED and is experiencing hyperosmolar hyperglycemic state (HHS)

Question

The nurse should prepare which fluid for resuscitation?

1. Normal saline and an insulin drip
2. Half normal saline and glipizide IV
3. 5% dextrose solution and half normal saline
4. 10% dextrose solution and potassium drip

Answer 1

Answer: 1

1. The client with type 2 diabetes mellitus is initially treated in a similar fashion to a client with type 1 diabetes mellitus. The goal is to rehydrate, stabilize electrolytes, and decrease glucose levels. The difference is that the insulin is stopped when the glucose is 250 because these clients do not experience DKA.
2. To correct electrolyte imbalances, the client is initially placed on a normal saline solution. Glipizide is not given IV.
3. For a client with type 1 diabetes mellitus, glucose is added to the saline solution when the glucose level is 250, and saline solution is reduced to half-normal saline.
4. A solution of 10% glucose is not administered initially. Potassium would be added to the saline fluids, and the combination of high glucose levels combined with insulin removes potassium from the client's blood.