A nurse is providing care for an older adult client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following clinical manifestations support the diagnosis? Select all that apply.
Acetone breath
Fever
68 years of age
Serum glucose 800 mg/dL (74 to 106 mg/dL)
Serum bicarbonate 15 mEq/L (21 to 28 mEq/L)
Insidious onset
Correct Answer : B,D,E,F
Choice A reason: Acetone Breath
Acetone breath is typically associated with diabetic ketoacidosis (DKA), not hyperosmolar hyperglycemic syndrome (HHS). In DKA, the body produces high levels of ketones, leading to a fruity or acetone-like breath odor. HHS, on the other hand, does not usually involve significant ketone production, so acetone breath is not a characteristic feature of HHS.
Choice B reason: Fever
Fever can be a clinical manifestation of HHS, often indicating an underlying infection, which is a common precipitating factor for HHS. Infections can exacerbate hyperglycemia and contribute to the development of HHS, making fever a relevant symptom to consider.
Choice C reason: 68 Years of Age
While age itself is not a clinical manifestation, HHS predominantly affects older adults, particularly those with type 2 diabetes. Therefore, being 68 years old is consistent with the typical demographic affected by HHS, but it is not a direct clinical manifestation.
Choice D reason: Serum Glucose 800 mg/dL
A serum glucose level of 800 mg/dL is significantly elevated and is a hallmark of HHS2. Normal serum glucose levels range from 74 to 106 mg/dL. Such high levels of glucose are indicative of severe hyperglycemia, which is a defining characteristic of HHS.
Choice E reason: Serum Bicarbonate 15 mEq/L
A serum bicarbonate level of 15 mEq/L is below the normal range of 21 to 28 mEq/L. This indicates metabolic acidosis, which can occur in HHS due to severe dehydration and impaired renal function. Although metabolic acidosis is more pronounced in DKA, it can still be present in HHS.
Choice F reason: Insidious Onset
HHS typically has an insidious onset, developing slowly over days to weeks. This gradual progression contrasts with the rapid onset of DKA and is a key feature in the clinical presentation of HHS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
Choice A Reason
Acetaminophen is often used to manage pain and fever, but it is not the primary treatment for pericarditis. While it can help alleviate discomfort, it does not address the inflammation associated with pericarditis12.
Choice B Reason:
Amiodarone is an antiarrhythmic medication used to treat and prevent various types of serious irregular heartbeats, such as ventricular tachycardia or ventricular fibrillation. It is not typically used for treating pericarditis, as it does not address the inflammation or pain associated with the condition.
Choice C Reason:
Colchicine is recommended as part of the first-line treatment for pericarditis. It helps reduce inflammation and the risk of recurrent pericarditis when used in conjunction with NSAIDs5. Colchicine is effective in managing symptoms and preventing recurrences.
Choice D Reason:
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is effective in reducing inflammation and pain associated with pericarditis. NSAIDs are commonly prescribed for pericarditis to help manage symptoms and reduce inflammation. Indomethacin, along with other NSAIDs like ibuprofen, is often part of the first-line treatment for this condition.
Choice E Reason:
Nitroglycerine is primarily used to treat angina (chest pain) and heart failure by dilating blood vessels and reducing the heart’s workload. It is not typically used for treating pericarditis, as it does not address the inflammation or pain associated with the condition.
Correct Answer is A
Explanation
Choice A Reason:
Insulin is stable at room temperature (between 59°F and 86°F) for up to one month. This is important for patients to know, especially if they do not have immediate access to refrigeration. However, it is crucial to avoid exposing insulin to extreme temperatures, such as direct sunlight or freezing conditions, as these can degrade the medication’s effectiveness.
Choice B Reason:
While some types of insulin can be mixed in the same syringe, this practice is not universally applicable to all insulin types. For example, rapid-acting and intermediate-acting insulins can sometimes be mixed, but long-acting insulins should not be mixed with other insulins. Therefore, this statement is not entirely accurate and should be clarified based on the specific types of insulin being used.
Choice C Reason:
Storing insulin in the freezer is not recommended as freezing can damage the insulin, rendering it ineffective. Insulin should be stored in a refrigerator at temperatures between 36°F and 46°F. If insulin is accidentally frozen, it should not be used.
Choice D Reason:
While it is advisable for clients with type 1 diabetes to have backup medication and supplies, storing them in a car is not recommended due to the potential for extreme temperature fluctuations. Insulin and other diabetes supplies should be kept in a stable, controlled environment to ensure their efficacy.
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