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What Is Hyperglycemic Hyperosmolar Syndrome?

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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

Hyperosmolar Hyperglycemic State (hhs)

Hyperosmolar hyperglycemic state is a complication of diabetes mellitus that most often occurs in type 2 diabetes. Symptoms of hyperosmolar hyperglycemic state include extreme dehydration and confusion. Hyperosmolar hyperglycemic state is diagnosed by blood tests that show very high levels of glucose and very concentrated blood. There are two types of diabetes mellitus, type 1 and type 2. In type 1 diabetes, the body produces almost no insulin, a hormone produced by the pancreas that helps sugar (glucose) move from the blood into the cells. In type 2 diabetes, the body produces insulin, but cells fail to respond normally to the insulin. In both types of diabetes. the amount of sugar (glucose) in the blood is elevated. If people with type 1 diabetes receive no insulin, or they need more insulin because of an illness, fat cells begin breaking down to provide energy. Fat cells that break down produce substances called ketones. Ketones provide some energy to cells but also make the blood too acidic (ketoacidosis). Diabetic ketoacidosis is a dangerous, sometimes life-threatening, disorder. Because people with type 2 diabetes produce some insulin, ketoacidosis does not usually develop ev Continue reading >>

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  1. kamaboko

    Hello,
    I've been on a Keto diet now for nine weeks. I am not diabetic. I'd just like to burn off some stomach fat. That said, I am simply starving at 20g of carbs per day. I've been using keto sticks to measure my ketosis levels (and yes I am aware that these sticks may not be the most accurate testing measure, but I'm not going to get a blood analysis every week). If I go beyond 20g per day, according to the keto stick results, I get thrown out of ketosis. How on earth does one stay at or below 20g of carbs per day? I should also say, prior to this diet, I was rarely a meat eater. I don't like bacon (pork or chicken varieties). Chicken and fish was always my choice.
    Prior to every meal I drink an 8oz glass of water with apple cider vinegar. I read this helps with digestion. I also drink lemon water throughout the day.
    Vegetables such as spinach or broccoli take my stomach forever to breakdown. I'm constantly bloated.
    Honestly, this has been a living Hell. What am I doing wrong?
    Typical day...
    Breakfast: Three AA large eggs and three slices of bacon.
    Lunch: Three cups of spinach. A half pound of ground beef with taco seasoning mix. Two tbsp of sour cream.
    Dinner. Three cups of spinach. Five ounces of chicken. One avocado. One roma tomato.
    Snacks are usually mozzarella or cheddar cheese sticks.

    Thanks,
    K



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    Summarize This Topic

  2. Brook

    This is going to be counterintuitive, but try going zero carb. Decide on a period of time like 3 weeks or 30 days, and eat no plant material at all for that period, then reassess. Some people find zero carb much easier to do than trying to stay very low carb. Figure you are going to est 2-3 times your current amount of meat. Eat all you want whenever you are hungry, but strictly from the animal kingdom. As much as you want of meat, fish, eggs. You can also have small amounts of cream, and full fat cheese, but view them as sides to meat, fish, or eggs.

  3. Jeff

    Fat to satiety. If you're hungry, add more fat. It's a wonderful way to deal with hunger pangs. I eat salami with cream cheese until I feel full. More bacon, butter with your avocado, or fatty cheeses. Don't be afraid to add more fat! Wishing you well.

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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 Hyperglycemic Hyperosmolar Syndrome

Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a potentially life threatening condition when a patient has extremely high blood sugar (glucose). It is usually a complication of type 2 diabetes and leads to severe dehydration and loss of consciousness if not treated. When infection, illness or medications spurs extremely high blood sugar in patients with type 2 diabetes, the cells do not have enough insulin or don’t respond to the insulin. The kidneys try to expel the glucose with increased urination. During diabetic hyperglycemic hyperosmolar syndrome, the body becomes extremely dehydrated. This level of dehydration can cause serious symptoms, including convulsions and coma. Continue reading >>

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  1. [deleted]

    I have had a terrible time sleeping since being on Keto, specifically in the last week. I do not want to stop though, I've lost 8 lbs in 24 days, I'm starting to PR more, and there are moments of clarity where the brain fog is at a minimum.
    NOTHING seems to keep me asleep. Usually I fall asleep in seconds and wake up 4 hours later wide awake but now I cannot even fall asleep. I try not to drink too much water before bed, exercise earlier in the afternoons 2-4 times a week, keep the tv/ smartphone out of the bedroom, and give myself some wind down time. I take the lowest does of Topamax for headaches and Alteril as a sleep aid. Any advice? Does this go away? I've been on some psych meds before for sleep, but none of them are truly designed to keep you asleep, only help you fall asleep.
    If you have any suggestions, I'd really appreciate it. I'm taking in about 70-90 grams of protein per day to keep my muscle mass, but I may have to down grade as protein can keep you awake.
    Thanks for any help you can give me.

  2. DownhillYardSale

    I've been on some psych meds before for sleep, but none of them are truly designed to keep you asleep, only help you fall asleep.
    Why?
    If this is the case keto isn't the cause of your sleep problems.
    I'm immediately looking towards stress/anxiety.

  3. DownhillYardSale

    You do not need to have mental health issues for stress/anxiety to affect your sleep.
    Any significant changes recently other than completely changing your diet?

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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, sala

Diabetic Hyperglycemic Hyperosmolar Syndrome

HHS; Hyperglycemic hyperosmolar coma; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Hyperosmolar nonketotic coma (HONK); Hyperglycemic hyperosmolar non-ketotic state; Diabetes - hyperosmolar Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes. It involves extremely high blood sugar (glucose) level without the presence of ketones. Causes HHS is a condition of: Buildup of ketones in the body (ketoacidosis) may also occur. But it is unusual and is often mild compared with diabetic ketoacidosis. HHS is more often seen in people with type 2 diabetes who don't have their diabetes under control. It may also occur in those who have not been diagnosed with diabetes. The condition may be brought on by: Infection Other illness, such as heart attack or stroke Medicines that decrease the effect of insulin in the body Medicines or conditions that increase fluid loss Normally, the kidneys try to make up for a high glucose level in the blood by allowing the extra glucose to leave the body in the urine. But this also causes the body to lose water. If you do not drink enough water, or you drink fluids that contain sugar and keep eating foods with carbohydrat Continue reading >>

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  1. sonias

    3 This is my topic for this week in nursing school, respiratory & metabolic acidosis/ alkalosis. I am having trouble breaking it down. Can someone please help me understand this please? Any and all help is greatly appreciated.

  2. Esme12

    Normal values:
    PH = 7.35 - 7.45
    C02 = 35 - 45
    HC03 = 21-26
    Respiratory acidosis = low ph and high C02
    hypoventilation (eg: COPD, narcs or sedatives, atelectasis)
    *Compensated by metabolic alkalosis (increased HC03)
    For example:
    ph 7.20 C02 60 HC03 24 (uncompensated respiratory acidosis)
    ph 7.33 C02 55 HC03 29 (partially compensated respiratory acidosis)
    ph 7.37 C02 60 HC03 37 (compensated respiratory acidosis)
    Respiratory alkalosis : high ph and low C02
    hyperventilation (eg: anxiety, PE, pain, sepsis, brain injury)
    *Compensated by metabolic acidosis (decreased HC03)
    examples:
    ph 7.51 C02 26 HC03 25 (uncompensated respiratory alkalosis)
    ph 7.47 C02 32 HC03 20 (partially compensated respiratory alkalosis)
    ph 7.43 C02 30 HC03 19 (compensated respiratory alkalosis)
    Metabolic acidosis : low ph and low HC03
    diabetic ketoacidosis, starvation, severe diarrhea
    *Compensated by respiratory alkalosis (decreased C02)
    examples:
    ph 7.23 C02 36 HC03 14 (uncompensated metabolic acidosis)
    ph 7.31 C02 30 HC03 17 (partially compensated metabolic acidosis)
    ph 7.38 C02 26 HC03 20 (compensated metabolic acidosis)
    Metabloic alkalosis = high ph and high HC03
    severe vomiting, potassium deficit, diuretics
    *Compensated by respiratory acidosis (increased C02)
    example:
    ph 7.54 C02 44 HC03 29 (uncompensated metabolic alkalosis)
    ph 7.50 C02 49 HC03 32 (partially compensated metabolic alkalosis)
    ph 7.44 C02 52 HC02 35 (compensated metabolic alkalosis)
    *Remember that compensation corrects the ph.
    Now a simple way to remember this......
    CO2 = acid, makes things acidic
    HCO3 = base, makes things alkalotic
    Remember ROME
    R-Respiratory
    O-Opposite
    M-Metabolic
    E-Equal
    Ok always look at the pH first...
    pH<7.35 = acidosis
    pH>7.45 = alkalosis
    Then, if the CO2 is high or low, then it is respiratory...If the HCO3 is high or low then it is metabolic. How you remember that is that the respiratory system is involved with CO2 (blowing air off or slowing RR), and the kidneys (metabolic) are involved with HCO3 (excreting or not excreting).
    Here is how you think thru it: pH = 7.25 CO2 = 40 HCO3 = 17
    Ok, first, the pH is low so think acidosis. CO2 is WNL. HCO3 is low. Draw arrows if it helps. The abnormal values are both low (think Equal). Metabolic imbalances are equal. So, this must be metabolic acidosis!
    Now, for compensation...If you have a metabolic imbalance, the respiratory system is going to try to compensate. Respiratory = CO2. If the CO2 is normal in the ABG, then there is no compensation going on. Compensation in acidosis will decrease the CO2 because you want to get rid of the acid (CO2). In alkalosis, it will increase because you want to add more acid (CO2)
    If you have a respiratory imbalance, the kidneys will try to compensate. Kidneys = HCO3. If the HCO3 is normal in the ABG, then there is no compensation going on. Compensation in acidosis will increase HCO3 because you want to hold on to the base to make it more alkalotic. In alkalosis, it will decrease because you want to excrete the base to make it more acidic.

  3. Esme12

    Check out this tutorial
    Interactive Online ABG's acid base

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