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NURSl 480/l NURS480l Examl 3l –l Advancedl Medicall Surgicall Healthl Nursing|l WCUl (Latestl 2026/l 2027l Update)l Review|l 100%l Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Whatl isl hyperglycemicl hyperosmolarl statel (HHS)?l
Answer:
Lifel threatening,l profoundl hyperglycemial ofl 600l mg/dLl orl greater,l hyperosmolarityl leadingl tol dehydrationl withl anl absencel ofl ketosis Onsetl isl graduall overl severall days Leadsl tol comal andl deathl ifl untreated
Q:l Isl hyperglycemicl hyperosmolarl statel (HHS)l morel commonl inl typel 1l orl typel 2l DM?l
Answer:
Typel 2
Q:l Whatl arel riskl factorsl forl hyperglycemicl hyperosmolarl statel (HHS)?l
Answer:
Osmoticl diuresisl duel tol lackl ofl sufficientl insulinl froml undiagnosedl orl poorlyl managedl DM Osmoticl diuresisl froml inadequatel fluidl orl poorl kidneyl function Olderl adultsl (50-70l yearsl old)l whol havel typel 2l DM Infection,l stress,l existingl medicall conditionsl (MI,l CVA,l sepsis) Medl effectsl (glucocorticoids,l thiazidel diuretics,l phenytoin,l betal blocker,l calciuml channell blockers) Therel isl enoughl insulinl tol preventl ketosisl butl notl enoughl tol preventl hyperglycemia
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Q:l Whatl arel expectedl findingsl ofl hyperglycemicl hyperosmolarl statel (HHS)?l
Answer:
3l P's Weightl loss Blurredl vision,l headache,l weakness Orthostaticl hypotension Alteredl mentall status Seizures,l myoclonicl jerkingl froml hyperosmolarityl greaterl thanl 350l mOsm/L Reversiblel paralysisl froml hyperosmolarity
Q:l Whatl labl resultsl arel seenl withl hyperglycemicl hyperosmolarl statel (HHS)?l
Answer:
Bloodl glucosel >l 600l mg/dL Checkl baselinel K+l andl Na+ BUNl >l 30l mg/dL,l creatininel >l 1.5l mg/dLl duel tol dehydration Absencel ofl ketonesl inl bloodl andl urine Bloodl osmolarityl >l 320l mOsm/L pHl >l 7.4 HCO3l >l 20l mEq/L
Q:l Whatl isl thel nursingl carel forl DKAl andl hyperglycemicl hyperosmolarl statel (HHS)?l
Answer:
Assessl vitalsl Q15Ml untill stable,l thenl Q4H Checkl forl indicationsl forl dehydrationl (weightl loss,l decreasedl skinl turgor,l oliguria,l rapid,l weakl pulse) Fluidl resuscitationl isl priority Treatl underlyingl causel (infection),l givel ABX Administerl isotonicl fluidsl (0.9?l NS,l LR)l followingl byl hypotonicl fluidsl (0.45%l NS) Hourlyl bloodl glucose Infusel continuousl regularl insulinl IV,l hasl tol runl onl itsl ownl line Whenl bloodl glucosel reachesl 250l mg/dL,l switchl IVFl tol 5%l dextrosel tol reducel riskl forl cerebrall edemal andl hypoglycemia Monitorl ABG,l electrolytesl andl replacel accordingly
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Q:l Whatl isl thel clientl educationl forl DKAl andl hyperglycemicl hyperosmolarl statel (HHS)?l
Answer:
Hydratel tol preventl dehydration Monitorl bloodl glucosel Q4Hl whenl sickl andl keepl takingl insulin Checkl urinel forl ketonesl ifl bloodl glucosel >l 240l mg/dL
Q:l Inl regardsl tol fluidl replacementl forl DMl andl HHS,l howl isl itl done?l Whatl kindl ofl fluidsl arel used?l
Answer:
Twol bagl system
Bagl 1:l 0.9%l NaCl,l 20l mEql KCl,l 20l mEql KPhos
Bagl 2:l Dextrosel 10%,l 0.9%l NaCl,l 20l mEql KCl,l 20l mEql KPhos
Q:l Ifl al patient'sl seruml glucosel isl greaterl thanl 300,l whatl wouldl thel ratel bel forl bagl 1l andl 2l whenl treatingl DMl andl HHSl usingl thel twol bagl system?l
Answer:
Bagl 1:l ratel ofl 250l mL/hr
Bagl 2:l 0
Q:l Ifl al patient'sl seruml glucosel isl lessl thanl 200-300,l whatl wouldl thel ratel bel forl bagl 1l andl 2l whenl treatingl DMl andl HHSl usingl thel twol bagl system?l
Answer:
Bagl 1:l ratel ofl 125l mL/hr
Bagl 2:l ratel ofl 125l mL/hr
Q:l Ifl al patient'sl seruml glucosel isl lessl thanl 200,l whatl wouldl thel ratel bel forl bagl 1l andl 2l whenl treatingl DMl andl HHSl usingl thel twol bagl system?l
Answer:
Bagl 1:l 0
Bagl 2:l ratel ofl 250l mL/hr
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Q:l Whatl isl acromegaly?l
Answer:
Excessl growthl hormones Affectsl bothl gendersl equally
Q:l Whyl doesl acromegalyl happen?l
Answer:
Occursl becausel ofl al benignl GHl secretingl pituitaryl adenomal (tumor)
Q:l Atl whatl agel isl acromegalyl typicallyl diagnosedl at?l
Answer:
40-45l yearsl old
Q:l Whatl arel expectedl findingsl ofl acromegaly?l
Answer:
Protrudingl jaw Headache Visuall disturbances Enlargedl handsl andl feet Increasingl handl size Sleepl apnea Menstruall changes Coarsel faciall features
Q:l Whatl diagnosticsl arel donel forl acromegaly?l Whyl arel theyl done?l
Answer:
X-rayl ofl thel skull:l identifyl abnormalitiesl ofl thel sellal turcica
CTl orl MRIl ofl head:l identifyl softl tissuel lesion
Cerebrall angiography:l evaluatel forl thel presencel ofl vascularl malformationl orl aneurysms GHl suppressionl test:l clientsl withl acromegalyl willl seel al slightl decreasel orl nol decreasel inl GH,l telll patientl tol consumel nothingl butl waterl forl 6-8l hrsl precedingl thel test
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