5 Hyperosmolar Hyperglycemic State Free Online FlashCards

What are the defining features of HHS?

HHS is a medical emergency marked by severe hyperglycemia, hyperosmolality, and dehydration, often with altered mental status.

How does HHS typically differ from DKA?

HHS usually involves absent or limited ketoacidosis, whereas DKA involves substantial ketone-related acidosis. The conditions can overlap, so assess the full clinical and laboratory picture.

What should the initial bedside assessment include in suspected HHS?

Assess airway, breathing, circulation, vital signs, mental status, hydration, and perfusion promptly.

Which tests and measurements help evaluate suspected HHS?

Check glucose, electrolytes, renal function, ketones, acid–base status with a venous blood gas, and serum osmolality; monitor urine output.

What should be investigated after initial HHS stabilization?

Investigate and treat the precipitating illness or event, such as infection, myocardial infarction, stroke, or missed or insufficient diabetes medication.

What is generally prioritized for a hypotensive, dehydrated adult with HHS?

Begin isotonic intravenous crystalloid replacement and reassess frequently; fluid replacement is a core early treatment.

What initial fluid rate may be used in adults without cardiac or renal compromise?

For adults without cardiac or renal compromise, consensus guidance describes isotonic saline or balanced crystalloid at 500–1,000 mL per hour for the first 2–4 hours, adjusted to clinical status.

What should be done before insulin if potassium is below $3.5$ mmol/L?

If potassium is below $3.5$ mmol/L, replace potassium under a monitored protocol and delay insulin until potassium is above that threshold.

Why can insulin be dangerous when potassium is low?

Insulin shifts potassium into cells and can worsen hypokalemia, making potassium assessment and close monitoring essential.

Why might measured sodium rise as glucose falls during HHS treatment?

Measured sodium may rise as glucose falls because water shifts back into cells. A rise alone does not automatically require hypotonic fluid.

How often should bedside glucose generally be checked during HHS treatment?

Check bedside glucose every 1–2 hours to guide treatment adjustments and detect complications.

How often are osmolality, electrolytes, and renal function generally reassessed initially?

Initially repeat serum osmolality, electrolytes, and renal-function tests about every 4 hours.