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Treatment For Dka And Hhs

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Hyperglycemic crises: Hyperglycemic hyperosmolar nonketotic coma (HHNK) versus DKA. See DKA video here: https://youtu.be/r2tXTjb7EqU This video and similar images/videos are available for instant download licensing here https://www.alilamedicalmedia.com/-/g... Voice by: Penelope Hammet Alila Medical Media. All rights reserved. All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Support us on Patreon and get FREE downloads and other great rewards: patreon.com/AlilaMedicalMedia Hyperosmolar hyperglycemic state, or HHS, is another ACUTE and life-threatening complication of diabetes mellitus. It develops slower than DKA, typically in the course of several days, but has a much higher mortality rate. Like DKA, HHS is triggered when diabetic patients suffer from ADDITIONAL physiologic stress such as infections, other illness, INadequate diabetic treatment or certain drugs. Similar to DKA, the RISE in COUNTER-regulatory hormones is the major culprit. These hormones stimulate FURTHER production and release of glucose into the blood, causing it to overflow into urine, resulting in excessive LOSS of water and electrolytes. The major DIFFERENCE between HHS and DKA is the ABSENCE of acidosis in HHS. This is because, unlike DKA, the level of insulin in HHS patients is HIGH enough to SUPPRESS lipolysis and hence ketogenesis. This explains why HHS occurs more often in type 2 diabetics, who have more or less normal level of circulating insulin. Reminder: type 2 diabetics DO produce insulin but their cells do NOT respond to insulin and therefore cannot use glucose. Because symptoms of acidosis are NOT present, development of HHS may go UNnoticed until blood glucose levels become EXTREMELY high. Severe dehydration results in INcreased concentrations of solutes in the blood, raising its osmolarity. HyPERosmotic blood plasma drives water OUT of bodys tissues causing cellular dysfunction. Primary symptom of HHS is ALTERED consciousness due to excessive dehydration of brain tissues. This can range from confusion to coma. Emergency treatment consists of intravenous fluid, insulin and potassium similar to those used in DKA.

66: Diabetic Ketoacidosis (dka) And Hyperosmolar Hyperglycemic State (hhs)

In this episode I’ll discuss diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Subscribe on iTunes, Android, or Stitcher Definition Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the most serious acute complications of diabetes. These diabetic crises cause thousands of deaths annually in the US. DKA and HHS differ clinically according to the presence of ketoacidosis and the degree of hyperglycemia. In DKA metabolic acidosis is often the major finding. The serum glucose is below 800 mg/dL and usually in the 350-500 mg/dL range. DKA usually evolves rapidly. In HHS, there is little or no ketoacidosis and the serum glucose concentration frequently exceeds 1000 mg/dL. HHS usually evolves over a period of several days. Overlap between DKA and HHS occurs in more than one-third of patients. Pathogenesis Insulin deficiency/resistance and glucagon excess are responsible for the development of DKA and HHS. The deficiency in insulin (either absolute or relative deficiency) is more severe in DKA compared with HHS. In HHS the residual insulin secretion and its systemic activity minimizes the development of ketoacidosis but is not adequate to co Continue reading >>

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  1. SWEETJAS

    HEY ALL!!
    I AM SOOOOO CONFUSED! I know some people don't think that the strips are accurate (their are many things that can effect the out come, how much water are you drinking, yadda, yadda, yadda) I had to try them !. I bought some last night and according to the color I am in Moderate ketosis. This morning I used one and it is the same. The strips go from Zero, Trace, Low, Moderate, to Large. So does the moderate mean that I AM buring fat as fuel or that I am ALMOST buring fat for fuel? The box and directions don't give and explanation for some odd reason.
    HEEEEELP!! Thanks!

  2. Cherimee

    On the side of the bottle, you should see a like a chart to compare it to.... if you are in moderate ketosis then that's good! The more purple the stick, the more fat you are burning for fuel, which is what you want to do on Atkins. You'll notice that with Atkins, the keto strips are like the scale, you wanna see PURPLE when you test becasue the more ketones in your urine, of course the more fat you burn! Sounds like you are doing good...good luck
    P.S. I'm told that with Atkins even a 'trace' of ketones is good... trying going to www dot lowcarbnexus dot com, that site gives you good info... here's what they say about ketosis:
    Ketosis? - As long as we are on the topic, what about ketosis? Ketosis is the state that your body enters into when you are eating mainly protein and fats, and drastically curtailing your consumption of carbohydrates. As Dr. Atkins says, "There is no lipolysis without ketosis, no ketosis without lipolysis." Lipolysis is, essentially, "fat burning." In other words, this is just what we want! We want to force our bodies to consume stored fat for fuel rather than burn primarily our food. This occurs because protein and fat do not "give up" their stored energy as easily as do carbohydrates. As long as you are eating mainly carbs, especially refined sugars, you will find that your body will burn that as opposed to your fat stores. Testing with LTS, as we have mentioned above, scientifically tests for the process of your body burning it's own fat as fuel. When the sticks turn purple (or a shade thereof), you are burning fat! It is a good feeling! It is especially comforting to see that purple when your scales don't agree that you are losing! Keep in mind that fat loss doesn't always equal weight loss on the scales... immediately. Body weight can be related to water retention, and many other temporary conditions. However, FAT loss is what we want, and you will see measurements change even if your scale does not show it immediately! That WILL follow, of course... just stick with it!
    Some have asked, "Do I have to be in ketosis?" Well, it is perfectly safe to be in what Dr. Atkins calls "Benign Dietary Ketosis" for extended periods. In fact, if you are burning fat, you will be in some amount of ketosis...sometimes just not a measurable amount (with LTS). If you are out of ketosis for extended periods, you won't be burning fat, and therefore, you won't be losing weight! And that's what we are doing the diet to do! Don't confuse ketosis, a safe metabolic state that you enter when you loss weight, with ketoacidosis, a dangerous state that diabetics, in particular, can enter if they get out of proper balance in their insulin / glycogen balance. Many health care professionals and nutritionists are apparently confused by the distinction between these two different states... ketone test strips are used to test both states, but they are quite different!

  3. SWEETJAS

    Cherimee, BIG THANKS!!!! The info you gave me is sooooo relieving!!! I was so worried! I know that must have takin a while for you to find and type, thank you so much for helping me!

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Visit us (http://www.khanacademy.org/science/he...) for health and medicine content or (http://www.khanacademy.org/test-prep/...) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Matthew McPheeters. Watch the next lesson: https://www.khanacademy.org/test-prep... Missed the previous lesson? https://www.khanacademy.org/test-prep... NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/b...). About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in and outside of the classroom. We tackle math, science, computer programming, history, art history, economics, and more. Our math missions guide learners from kindergarten to calculus using state-of-the-art, adaptive technology that identifies strengths and learning gaps. We've also partnered with institutions like NASA, The Museum of Modern Art, The California Academy of Sciences, and MIT to offer specialized content. For free. For everyone. Forever. #YouCanLearnAnything Subscribe to Khan Academys NCLEX-RN channel: https://www.youtube.com/channel/UCDx5... Subscribe to Khan Academy: https://www.youtube.com/subscription_...

Hyperosmolar Hyperglycemic State Treatment & Management

Approach Considerations Diagnosis and management guidelines for hyperglycemic crises are available from the American Diabetes Association. [6, 10, 24] The main goals in the treatment of hyperosmolar hyperglycemic state (HHS) are as follows: In an emergency situation, whenever possible, contact the receiving facility while en route to ensure preparation for a comatose, dehydrated, or hyperglycemic patient. When appropriate, notify the facility of a possible cerebrovascular accident or myocardial infarction (MI). Initiation of insulin therapy in the emergency department (ED) through a subcutaneous insulin pump may be an alternative to intravenous (IV) insulin infusion. [25] Airway management is the top priority. In comatose patients in whom airway protection is of concern, endotracheal intubation may be indicated. Rapid and aggressive intravascular volume replacement is always indicated as the first line of therapy for patients with HHS. Isotonic sodium chloride solution is the fluid of choice for initial treatment because sodium and water must be replaced in these severely dehydrated patients. Although many patients with HHS respond to fluids alone, IV insulin in dosages similar to Continue reading >>

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  1. Hans Luijendijk

    Ketosis is a normal metabolic process in your body. If you don't have sufficient glucose in your body, it will turn to burning fat. A process we call ketosis.
    It does not cause kidney damage in healthy people with normal balanced food intake.

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DKA (Diabetic Ketoacidosis) Vs HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome) Tables From Step Up to Medicine (3rd Edition, Agabegi) Here is the link for the Quick Hits =) http://imgur.com/TnJPBmu

Diabetic Ketoacidosis And Hyperosmolar Hyperglycemic State In Adults: Treatment

INTRODUCTION Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS, also known as hyperosmotic hyperglycemic nonketotic state [HHNK]) are two of the most serious acute complications of diabetes. They are part of the spectrum of hyperglycemia, and each represents an extreme in the spectrum. The treatment of DKA and HHS in adults will be reviewed here. The epidemiology, pathogenesis, clinical features, evaluation, and diagnosis of these disorders are discussed separately. DKA in children is also reviewed separately. (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis".) (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis".) Continue reading >>

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  1. RedhairedNurse

    Your nursing text should point out the difference. I would tell you, but I'd just have to look it up and my books are in storage. I could also google it, but something you can also do as well. Sorry.

  2. RedhairedNurse

    http://books.google.com/books?id=aLt...um=9&ct=result

  3. Ilithya

    In HHNS, blood sugar levels rise, and your body tries to get rid of the excess sugar by passing it into your urine, your body tries to compensate. This usually happens to type 2s
    In DKA there is little to no circulating insulin. DKA occurs mainly, but not exclusively, in Type 1 diabetes because Type 1 diabetes is characterized by a lack of insulin production in the pancreas. It is much less common in Type 2 diabetes because the latter is closely related to cell insensitivity to insulin, not -- at least initially -- to a shortage or absence of insulin. Some Type 2 diabetics have lost their own insulin production and must take external insulin; they have some susceptibility to DKA. You get acidosis in DKA because ketones lower the bloods pH.
    Does that help?

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