Which of the following evaluation data would the nurse recognize that a patient with hyperosmolar hyperglycemic syndrome (HHS) has improved during the first 24 hours upon admission to the hospital?

Alert and oriented, blood and urine without ketones, no orthostatic blood pressure changes.

Alert and oriented, balanced intake and output, moist mucous membranes.

Respirations easy and unlabored, eats 50-75% of meals, vital signs stable.

Equal intake and output, denies pain or shortness of breath.

Answer and Explanation

The Correct Answer is A

A. Alert and oriented, blood and urine without ketones, no orthostatic blood pressure changes – These findings indicate improved hydration, resolution of hyperosmolarity, and recovery of neurological function, key markers of HHS improvement.

B. Alert and oriented, balanced intake and output, moist mucous membranes – While improved hydration is good, ketone clearance and hemodynamic stability are more important indicators.

C. Respirations easy and unlabored, eats 50-75% of meals, vital signs stable – Respiratory status is not the primary concern in HHS.

D. Equal intake and output, denies pain or shortness of breath – These signs do not specifically indicate resolution of HHS.

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Correct Answer is D

Explanation

A. Rowing. – Incorrect. Rowing can strain the lower back.

B. Tennis. – Incorrect. Twisting motions in tennis can exacerbate back pain.

C. Canoeing. – Incorrect. Similar to rowing, canoeing may strain the lower back.

D. Swimming. – Correct Answer. Water-based exercises provide low-impact movement and reduce strain on the spine, making swimming the best choice.

A. Hct 45% B. Hgb 14.7 g/dL C. WBC 1,700/mm3 D. Platelets 160,000/mm3

Correct Answer is C

Explanation

A. Hct 45%. – Normal range for hematocrit (Hct) is 38-50%. No need to report.

B. Hgb 14.7 g/dL. – Normal range for hemoglobin (Hgb) is 13-17 g/dL. No need to report.

C. WBC 1,700/mm³. – Correct Answer. Normal WBC count is 4,000-11,000/mm³. A WBC count of 1,700/mm³ (neutropenia) places the patient at high risk for infection, requiring immediate intervention.

D. Platelets 160,000/mm³. – Normal range for platelets is 150,000-450,000/mm³. No need to report.

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Which of the following evaluation data would the nurse recognize that a patient with hyperosmolar hyperglycemic syndrome (HHS) has improved during the first 24 hours upon admission to the hospital?

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