A nurse is providing care for an older adult client who has hyperglycemia, polydipsia, and polyuria. Which of the following manifestations supports the clinical presentation of hyperosmolar hyperglycemic syndrome (HHS)? (Select All that Apply.)
Acetone breath.
Fever.
Serum glucose 800 mg/dL (74 to 106 mg/dL).
Serum bicarbonate 15 mEq/L (21 to 28 mEq/L).
Insidious onset.
Correct Answer : B,C,E
Choice A rationale
Acetone breath is a characteristic symptom of diabetic ketoacidosis (DKA), not hyperosmolar hyperglycemic syndrome (HHS). In DKA, the body produces ketones, leading to a fruity or acetone-like breath odor. HHS, on the other hand, does not typically involve significant ketone production.
Choice B rationale
Fever can be a manifestation of HHS, often due to an underlying infection or illness that precipitates the hyperglycemic state. Infections are common triggers for HHS, leading to elevated body temperature.
Choice C rationale
Serum glucose levels of 800 mg/dL are indicative of HHS. HHS is characterized by extremely high blood glucose levels, often exceeding 600 mg/dL, without significant ketoacidosis.
Choice D rationale
Serum bicarbonate levels of 15 mEq/L are more indicative of DKA rather than HHS. In HHS, bicarbonate levels are usually within the normal range because there is no significant ketoacidosis.
Choice E rationale
Insidious onset is a hallmark of HHS. The condition develops gradually over days to weeks, unlike DKA, which has a more rapid onset.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale
A serum creatinine test does not inform the provider about anemia. Anemia is typically diagnosed through a complete blood count (CBC) test, which measures the levels of hemoglobin and hematocrit in the blood.
Choice B rationale
A serum creatinine test does not provide information about infections. Infections are usually diagnosed through clinical evaluation and specific tests such as blood cultures, urine cultures, or imaging studies.
Choice C rationale
A serum creatinine test measures the level of creatinine in the blood, which is an indicator of kidney function. Elevated creatinine levels can indicate impaired kidney function or kidney disease.
Choice D rationale
A serum creatinine test does not provide information about thyroid disorders. Thyroid function is typically assessed through tests that measure levels of thyroid hormones (T3 and T4) and thyroid-stimulating hormone (TSH) in the blood.
Correct Answer is A
Explanation
Choice A rationale
Monitoring potassium levels is essential when taking thiazide diuretics because these medications can cause hypokalemia (low potassium levels). Regular blood tests help ensure that potassium levels remain within a safe range.
Choice B rationale
Limiting alcohol consumption to 3 drinks a day is not recommended for individuals with hypertension. Excessive alcohol intake can raise blood pressure and negate the benefits of other lifestyle modifications.
Choice C rationale
Setting a goal body weight within 25% of ideal body weight is not an appropriate recommendation. The goal should be to achieve and maintain a healthy weight, which is typically defined as a BMI within the normal range.
Choice D rationale
Lowering sodium intake to 3,000 mg each day is still above the recommended limit. The American Heart Association recommends reducing sodium intake to less than 2,300 mg per day, with an ideal limit of 1,500 mg per day for most adults.
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