Question

do a diet plan = tips for acute hyperglycemia and hyperosmolar do a plan and goal of treatment/interventions

Answer 1

Acute hyperglycemia and hyperosmolar state (HHNS) is a life threatening condition of a hyperglycemic state that affect patient with DM .it present with an extreme high blood glucose which cause the blood to become very concentrated hyperosmolar but without the breakdown of ketones.

Therefore clinically will have heavy duty hyperglycemia , hyperosmolara dehydration

Plan of the treatment

To vigorously rehydrate the patient while maintaining electrolyte homeostasis

To correct hyperglycemia

To treat underlying disease

To monitor and assist cardiovascular, pulmonary,renal,CNS function

Nursing intervention

1.hydration

Administration of IV fluids such as .9°%normal saline and progress to.45%NSto hydrate the cell (depend on how hydrate the patient is)

5%dextrose may be added to .45%NS when glucose is around250to300mg/dl.this will help gradually bring the blood sugar down and help the insulin do it's job by removing ketones

2.administation of insulin(only type given IV)make sure K+is normal>3.3

Typically started out by giving unit IV bolus then start an infusion . you Will be titrating the insulin base on blood glucose checks

Note..if you rapidly bring patient's blood glucose down or up the brain can't cope and water will be moved from blood to CSF and you Will get cerebral edema and increasef intracranial pressure

3.watch pottasium level very closely because insulin cause K+to move back into the cell

Administration pottasium solution IV to combat this.note renal function before administration