NURS 618 Saunders Med Surg Endocrine Revised 2020.

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NURS 618 Saunders Med Surg Endocrine Revised 2020 Saunders Med Surg Endocrine 1. A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglyc... emic syndrome is made. The nurse would immediately prepare to initiate which anticipated health care provider's prescription? 1. Endotracheal intubation 2. 100 units of NPH insulin 3. Intravenous infusion of normal saline 4. Intravenous infusion of sodium bicarbonate Answer: 3. Intravenous infusion of normal saline Rationale: The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client to restore fluid volume and to correct electrolyte deficiency. Intravenous (IV) fluid replacement is similar to that administered in diabetic ketoacidosis (DKA) and begins with IV infusion of normal saline. Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct acidosis is avoided because it can precipitate a further drop in serum potassium levels. Intubation and mechanical ventilation are not required to treat HHS. [Show More]

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