Hyperosmolar Hyperglycemic State

Endocrine Disfunctions

Hyperosmolar Hyperglycemic State

extreme hyperglycemic + dehydrated BS >600

blood concentrated: hyperosmolarity

no breakdown of fats

presentable in Type 2

Pathophysiology HHS

blood is resistant of glucose which stays in the body and causes water to be pulled out of the cells to cause dehydration. Although the glucose is not interacting with the insulin there is just enough insulin to not break down fat. High glucose production causes the kidney to decrease reabsorption causing leakage into the urine causing osmotic diuresis

Signs of HHS

extreme elevation of blood sugar above 600

polyuria: excessive urination

polydipsia: extreme thirst due to dehydration

dry mucus membrane

dehydration

fever

fatigue

mental health changes

Pnemonic Manifestations

HHNS

H- highest sugar

H- high fluid loss polyuria

N- No abdominal pain

S- Slower Onset

HHS Interventions

First: IV fluid of Bolus 0.9% NS

• 0.45% NS to hydrate cells caution of cerebral edema

• 5% dextrose when BS 250 to 300 BS dropping gradually

Regular Insulin

• monitor Potassium