Teaching a patient who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized?
The nurse is caring for a patient with type 2 diabetes mellitus who has been prescribed doses of insulin.

Monitoring blood glucose levels

Recognizing signs and symptoms of HHS

Administering insulin correctly

Understanding the importance of hydration

Managing diet and nutrition

Answer and Explanation

The Correct Answer is B

Choice A Reason:

Monitoring blood glucose levels is crucial for managing diabetes, but in the context of hyperosmolar hyperglycemic syndrome (HHS), recognizing the signs and symptoms is more critical. HHS is a serious condition characterized by extremely high blood sugar levels without significant ketoacidosis. Early recognition of symptoms such as extreme thirst, frequent urination, confusion, and weakness can prevent complications and prompt timely medical intervention.

Choice B Reason:

Recognizing signs and symptoms of HHS is the most important topic to prioritize. HHS can develop gradually and may be life-threatening if not identified and treated promptly. Patients and caregivers need to be aware of the warning signs to seek immediate medical attention. Symptoms include severe dehydration, altered mental status, and very high blood glucose levels. Educating patients on these signs ensures they can act quickly to prevent severe outcomes.

Choice C Reason:

Administering insulin correctly is essential for managing diabetes, but it is not the top priority in the context of HHS education. While proper insulin administration helps control blood glucose levels, the immediate concern in HHS is recognizing the condition’s onset. Once HHS is identified, insulin administration becomes part of the treatment plan, but early detection is key to preventing severe complications.

Choice D Reason:

Understanding the importance of hydration is important because dehydration is a significant component of HHS. Patients with HHS often experience severe dehydration due to high blood glucose levels leading to osmotic diuresis. Educating patients on maintaining adequate hydration can help manage their condition and prevent the onset of HHS. However, recognizing the symptoms of HHS remains the top priority.

Choice E Reason:

Managing diet and nutrition is a fundamental aspect of diabetes care, but it is not the primary focus when dealing with HHS. While a balanced diet helps maintain stable blood glucose levels, the immediate concern in HHS is identifying and responding to the condition’s symptoms. Once HHS is recognized and treated, dietary management becomes part of the long-term care plan.

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Correct Answer is A

Explanation

Choice A reason:

Keeping supplies on hand to treat hypoglycemic episodes is crucial for clients with type 1 diabetes mellitus. Hypoglycemia, or low blood sugar, can occur suddenly and needs immediate treatment to prevent severe complications such as loss of consciousness or seizures. Supplies such as glucose tablets, juice, or candy can quickly raise blood sugar levels. The American Diabetes Association recommends that individuals with diabetes always carry a source of fast-acting carbohydrate to treat hypoglycemia. This proactive approach ensures that clients can manage their condition effectively and reduce the risk of severe hypoglycemic events.

Choice B reason:

Increasing exercise can help with hypoglycemia is not an appropriate statement. While regular exercise is beneficial for managing diabetes overall, it can actually increase the risk of hypoglycemia, especially if not properly managed. Exercise increases insulin sensitivity, which can lower blood glucose levels. Therefore, clients need to monitor their blood sugar levels before, during, and after exercise and adjust their carbohydrate intake or insulin dosage accordingly. Advising increased exercise without proper guidance on managing blood sugar levels can be dangerous for clients with type 1 diabetes.

Choice C reason:

Clients with hypoglycemia cannot participate in religious/cultural fasting is not entirely accurate. While fasting can pose challenges for individuals with diabetes, it is not impossible. Clients can participate in fasting with careful planning and medical supervision. They need to monitor their blood sugar levels more frequently and adjust their medication and food intake accordingly. Healthcare providers can work with clients to develop a plan that allows them to observe their religious or cultural practices safely. Therefore, a blanket statement that clients cannot participate in fasting is not appropriate.

Choice D reason:

Clients will usually have obvious manifestations of hypoglycemia is not always true. Hypoglycemia can present with a variety of symptoms, and not all clients will experience obvious signs. Common symptoms include shakiness, sweating, confusion, and irritability, but some individuals may have hypoglycemia unawareness, where they do not recognize the symptoms until their blood sugar levels are very low. This condition can be particularly dangerous as it increases the risk of severe hypoglycemia. Therefore, it is important for clients to regularly monitor their blood sugar levels rather than relying solely on symptoms.

A. Acetone breath B. Fever C. 68 years of age D. Serum glucose 800 mg/dL (74 to 106 mg/dL) E. Serum bicarbonate 15 mEq/L (21 to 28 mEq/L) F. Insidious onset

Correct Answer is ["B","D","E","F"]

Explanation

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.

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Teaching a patient who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized?The nurse is caring for a patient with type 2 diabetes mellitus who has been prescribed doses of insulin.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client who has type 1 diabetes mellitus and has been experiencing hypoglycemic episodes. Which of the following statements by the nurse is appropriate?

Correct Answer is A

Explanation

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.

Correct Answer is ["B","D","E","F"]

Explanation

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Teaching a patient who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized?
The nurse is caring for a patient with type 2 diabetes mellitus who has been prescribed doses of insulin.