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What Is Hhns Diabetes?

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Hyperglycemic hyperosmolar nonketotic syndrome (HHNS or HHS) nursing diabetes & pathophysiology NCLEX review on endocrine disorders of the body. HHNS vs DKA are two complications of diabetes mellitus. HHNS presents with extreme hyperglycemia (blood glucose greater than 600 mg/dL) and dehyrdation. Ketones and acidosis are not present in this condition as with diabetic ketoacidosis. The hyperglycemia hyperosmolar state can lead to a coma and even death if not treated promptly. HHNS treatment includes intravenous fluids, insulin therapy,and electrolyte replacement. This video will highlight the patho, causes, signs and symptoms, and nursing interventions for HHS. Please see the previous videos on DKA and DKA vs HHS (see the playlist below) Quiz on HHNS: http://www.registerednursern.com/hhns... Lecture Notes for this Video: http://www.registerednursern.com/hhns... Diabetes Lecture Videos: https://www.youtube.com/playlist?list... Subscribe: http://www.youtube.com/subscription_c... Nursing School Supplies: http://www.registerednursern.com/the-... Nursing Job Search: http://www.registerednursern.com/nurs... Visit our website RegisteredNurseRN.com for free quizzes, nursing care plans, salary information, job search, and much more: http://www.registerednursern.com Check out other Videos: https://www.youtube.com/user/Register... Popular Playlists: "NCLEX Study Strategies": https://www.youtube.com/playlist?list... "Fluid & Electrolytes Made So Easy": https://www.youtube.com/playlist?list... "Nursing Skills Videos": https://www.youtube.com/playlist?list... "Nursing School Study Tips": https://www.youtube.com/playlist?list... "Nursing School Tips & Questions": https://www.youtube.com/playlist?list... "Teaching Tutorials": https://www.youtube.com/playlist?list... "Types of Nursing Specialties": https://www.youtube.com/playlist?list... "Healthcare Salary Information": https://www.youtube.com/playlist?list... "New Nurse Tips": https://www.youtube.com/playlist?list... "Nursing Career Help": https://www.youtube.com/playlist?list... "EKG Teaching Tutorials": https://www.youtube.com/playlist?list... "Personality Types": https://www.youtube.com/playlist?list... "Dosage & Calculations for Nurses": https://www.youtube.com/playlist?list... "Diabetes Health Managment": https://www.youtube.com/playlist?list...

What Is Hyperosmolar Hyperglycemic Nonketotic Syndrome?

Having diabetes means that there is too much sugar (glucose) in your blood. When you eat food, your body breaks down much of the food into glucose. Your blood carries the glucose to the cells of your body. An organ in your upper belly, called the pancreas, makes and releases a hormone called insulin when it detects glucose. Your body uses insulin to help move the glucose from the bloodstream into the cells for energy. When your body does not make insulin (type 1 diabetes), or has trouble using insulin (type 2 diabetes), glucose cannot get into your cells. The glucose level in your blood goes up. Too much glucose in your blood (also called hyperglycemia or high blood sugar) can cause many problems. People with type 2 diabetes are at risk for a problem called hyperosmolar hyperglycemic nonketotic syndrome (HHNS). It is very rare in people with type 1 diabetes. HHNS is an emergency caused by very high blood sugar, often over 600 mg/dL. Your kidneys try to get rid of the extra blood sugar by putting more sugar into the urine. This makes you urinate more and you lose too much body fluid, causing dehydration. As you lose fluids, your blood becomes thicker and your blood sugar level gets Continue reading >>

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  1. Nineways

    I've been doing the keto diet for about 2 weeks already, I've lost 9 pounds already following the diet, I've also done a lot of exercise and counting my calories with MFP.
    The thing is that I don't know if I'm loosing weight just because I'm eating less calories and doing exercise or because i'm also in Ketosis...
    I don't really know if my pee smells worse, neither I feel a metallic breath (just whenever my mouth is dry is the time that I feel that my breath stinks, but don't know if this means something), and I've looked everywhere in my city for those ketostix but I guess they are not common here in Colombia...
    So my question really is, if there's another way to know if i'm in ketosis...
    Thanks!

  2. EnochScribe

    Eating less than 25g carbs a day [√]
    Not eating 300g+ protein a day [√]
    If you have fulfilled those requirements for at least 2-3 days, you'll be in ketosis.
    Don't even bother with the ketostix, they're inaccurate. You'll be in ketosis as long as you don't eat too many carbs or eat a ridiculous amount of protein.
    Losing weight is just eating less calories, keto just helps you fill satisfied while doing so which in return makes a higher deficit easier for some. You don't instantly start dropping pounds by eating keto friendly foods, it's entirely possible to gain weight while in ketosis. It all comes down to calories.

  3. NotElizaHenry

    Are ketostix really inaccurate? I've never heard that before.

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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 Hyperglycemic Hyperosmolar Syndrome

In Brief Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Mortality rates are 2–5% for DKA and 15% for HHS, and mortality is usually a consequence of the underlying precipitating cause(s) rather than a result of the metabolic changes of hyperglycemia. Effective standardized treatment protocols, as well as prompt identification and treatment of the precipitating cause, are important factors affecting outcome. The two most common life-threatening complications of diabetes mellitus include diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Although there are important differences in their pathogenesis, the basic underlying mechanism for both disorders is a reduction in the net effective concentration of circulating insulin coupled with a concomitant elevation of counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). These hyperglycemic emergencies continue to be important causes of morbidity and mortality among patients with diabetes. DKA is reported to be responsible fo Continue reading >>

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  1. treehorn+bunny

    You don't need to be in DKA to get ketosis. It's probably because he hasn't been eating enough/is sick. It is not uncommon for people who have stomach viruses to burn ketones.
    In nondiabetic persons, ketonuria may occur during acute illness or severe stress.

  2. PorcineWithMe

    GERD/reflux/"heartburn" can cause that smell and so can taking Prilosec (or other PPIs). My husband had THE WORST breath from taking Prilosec. Ugh.

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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

Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis.[4] Symptoms include signs of dehydration, weakness, legs cramps, trouble seeing, and an altered level of consciousness.[2] Onset is typically over days to weeks.[3] Complications may include seizures, disseminated intravascular coagulopathy, mesenteric artery occlusion, or rhabdomyolysis.[2] The main risk factor is a history of diabetes mellitus type 2.[4] Occasionally it may occur in those without a prior history of diabetes or those with diabetes mellitus type 1.[3][4] Triggers include infections, stroke, trauma, certain medications, and heart attacks.[4] Diagnosis is based on blood tests finding a blood sugar greater than 30 mmol/L (600 mg/dL), osmolarity greater than 320 mOsm/kg, and a pH above 7.3.[2][3] Initial treatment generally consists of intravenous fluids to manage dehydration, intravenous insulin in those with significant ketones, low molecular weight heparin to decrease the risk of blood clotting, and antibiotics among those in whom there is concerns of infection.[3] The goal is a slow decline in blood sug Continue reading >>

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  1. metalmd06

    Does acute DKA cause hyperkalemia, or is the potassium normal or low due to osmotic diuresis? I get the acute affect of metabolic acidosis on potassium (K+ shifts from intracellular to extracellular compartments). According to MedEssentials, the initial response (<24 hours) is increased serum potassium. The chronic effect occuring within 24 hours is a compensatory increase in Aldosterone that normalizes or ultimatley decreases the serum K+. Then it says on another page that because of osmotic diuresis, there is K+ wasting with DKA. On top of that, I had a question about a diabetic patient in DKA with signs of hyperkalemia. Needless to say, I'm a bit confused. Any help is appreciated.

  2. FutureDoc4

    I remember this being a tricky point:
    1) DKA leads to a decreased TOTAL body K+ (due to diuresis) (increase urine flow, increase K+ loss)
    2) Like you said, during DKA, acidosis causes an exchange of H+/K+ leading to hyperkalemia.
    So, TOTAL body K+ is low, but the patient presents with hyperkalemia. Why is this important? Give, insulin, pushes the K+ back into the cells and can quickly precipitate hypokalemia and (which we all know is bad). Hope that is helpful.

  3. Cooolguy

    DKA-->Anion gap M. Acidosis-->K+ shift to extracellular component--> hyperkalemia-->symptoms and signs
    DKA--> increased osmoles-->Osmotic diuresis-->loss of K+ in urine-->decreased total body K+ (because more has been seeped from the cells)
    --dont confuse total body K+ with EC K+
    Note: osmotic diuresis also causes polyuria, ketonuria, glycosuria, and loss of Na+ in urine--> Hyponatremia
    DKA tx: Insulin (helps put K+ back into cells), and K+ (to replenish the low total potassium
    Hope it helps

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