Which of the following clients is at greatest risk for hyperglycemic hyperosmolar syndrome (HHS)?

88-year-old person with only Type 2 diabetes.

72-year-old person with Type 2 diabetes & COPD.

33-year old person with Type 1 diabetes.

56-year old person with only Type 2 diabetes.

Answer and Explanation

The Correct Answer is B

A.   Older adults, particularly those with Type 2 diabetes, are at increased risk for HHS due to factors such as decreased renal function, polypharmacy, and potential for dehydration. This patient's age and diabetes type make them susceptible, but we need to compare them with other options.
B.   COPD can lead to respiratory problems that may further complicate diabetes management. Additionally, older adults with chronic diseases often experience increased stress on their bodies, which can exacerbate hyperglycemia. The combination of age, diabetes, and a chronic respiratory condition increases the risk.
C.   While individuals with Type 1 diabetes can experience HHS, it is less common compared to those with Type 2 diabetes. This is primarily because people with Type 1 diabetes are more prone to ketoacidosis rather than HHS, especially if they are managing their insulin properly. Therefore, this individual is at a lower risk for HHS.
D.   This patient has Type 2 diabetes but lacks the additional risk factors (like older age or chronic illness) that would significantly elevate their risk for HHS compared to the other options. While they could develop HHS, they are not at the highest risk.

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Correct Answer is C

Explanation

A. While calamine lotion can be soothing and help alleviate itching, applying a thick coat over open lesions is not advisable. It may not allow the skin to breathe and can potentially lead to further irritation or infection. Therefore, while this option has some merit, it is not the priority intervention.
B. Diphenhydramine (Benadryl) is an antihistamine that can help relieve itching. This option can be beneficial for managing pruritus and may help the child sleep better. However, while it can be useful, there are other interventions that can provide immediate comfort more effectively.
C. Applying a cool cloth to the rash is an immediate and effective way to provide comfort and relieve itching. The coolness can soothe inflamed skin and reduce the urge to scratch, which helps prevent secondary infections.
D. While giving ibuprofen or acetaminophen can help reduce fever and discomfort associated with varicella, it does not specifically address pruritus. These medications are helpful for pain management but are not the best choice for alleviating itching directly.

A. Altered mental status and dehydration B. Hemoptysis and dyspnea C. Pleuritic chest pain and hypertension D. Fever and chills

Correct Answer is D

Explanation

A. While altered mental status can occur in older adults with pneumonia, especially due to hypoxia or infection, it is often a result of more advanced disease or complications rather than an early symptom. Dehydration can also occur but is not a direct symptom of pneumonia.
B. Hemoptysis (coughing up blood) is not a common early symptom of pneumonia, especially in older adults. Dyspnea (difficulty breathing) may occur, but it generally arises as the pneumonia worsens. These symptoms might not be the first to present.
C. Pleuritic chest pain (pain upon breathing) can be associated with pneumonia but is not necessarily an early symptom, especially in the elderly. Hypertension may be present but is not a hallmark of pneumonia and can vary widely among patients.
D. Fever and chills are common initial symptoms of pneumonia and are part of the body’s response to infection. In elderly patients, fever may sometimes be less pronounced or atypical, but it is still one of the first signs of pneumonia.

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Which of the following clients is at greatest risk for hyperglycemic hyperosmolar syndrome (HHS)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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