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 D

Explanation

Choice A Reason:

Decreasing activity is not recommended for managing peripheral venous disease. Regular physical activity, such as walking, helps improve blood circulation and can reduce symptoms. Inactivity can lead to worsening of the condition and increase the risk of complications.

Choice B Reason:

Massaging the legs frequently is not typically recommended for preventing fluid buildup in peripheral venous disease. Instead, compression therapy, such as wearing compression stockings, is more effective in managing symptoms and preventing fluid accumulation.

Choice C Reason:

Keeping the legs in a dependent position (hanging down) can worsen symptoms of peripheral venous disease. Elevating the legs above heart level helps reduce swelling and improve blood flow, which is beneficial for managing the condition.

Choice D Reason:

Inspecting the legs daily for changes in color, size, and temperature is crucial for managing peripheral venous disease. This practice helps in early detection of complications such as infections, ulcers, or worsening of the condition, allowing for timely medical intervention.

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 teaching a client who has peripheral venous disease about management of symptoms. Which of the following client statements indicates to the nurse an understanding of the teaching?

Correct Answer is D

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.