Question
Which of the following treatments of hyperosmolar hyperglycemic syndrome or HHS is CORRECT?
Group of answer choices
“Intravenous fluids are administered before administering IV insulin to the client as insulin can cause extracellular fluid to move intracellularly and result in more hypotension.”
“IV insulin will be administered until blood glucose is 150 mg/dL and the patient will be fluid restricted to increase sodium.”
“Subcutaneous insulin is given first, then IV insulin if needed.”
“Only oral fluid administration should be used as IV fluid will lead to increased chances of CHF.”
Group of answer choices
“Intravenous fluids are administered before administering IV insulin to the client as insulin can cause extracellular fluid to move intracellularly and result in more hypotension.”
“IV insulin will be administered until blood glucose is 150 mg/dL and the patient will be fluid restricted to increase sodium.”
“Subcutaneous insulin is given first, then IV insulin if needed.”
“Only oral fluid administration should be used as IV fluid will lead to increased chances of CHF.”
Answers
GPT-4o mini
The correct treatment approach for hyperosmolar hyperglycemic syndrome (HHS) is:
**“Intravenous fluids are administered before administering IV insulin to the client as insulin can cause extracellular fluid to move intracellularly and result in more hypotension.”**
In HHS, it is critical to initiate rehydration with intravenous fluids before starting insulin therapy. This is because administering insulin can lead to a shift of fluids from the extracellular space to the intracellular space, which can exacerbate hypotension in a patient who is already volume-depleted. Therefore, addressing fluid deficits first is essential in managing HHS.
The other options presented are incorrect for the following reasons:
- The second option incorrectly states that IV insulin will be stopped once blood glucose reaches 150 mg/dL; typically, insulin continues until the blood glucose is at a safe level, and fluid replacement is ongoing.
- The third option is not in line with current practice; IV insulin is preferred in the acute management of HHS.
- The fourth option is inaccurate because oral fluid administration is inadequate and inappropriate in the acute setting of HHS where patients are often severely dehydrated and may not be able to tolerate oral intake.
Thus, the first option is the best choice regarding the treatment of HHS.
**“Intravenous fluids are administered before administering IV insulin to the client as insulin can cause extracellular fluid to move intracellularly and result in more hypotension.”**
In HHS, it is critical to initiate rehydration with intravenous fluids before starting insulin therapy. This is because administering insulin can lead to a shift of fluids from the extracellular space to the intracellular space, which can exacerbate hypotension in a patient who is already volume-depleted. Therefore, addressing fluid deficits first is essential in managing HHS.
The other options presented are incorrect for the following reasons:
- The second option incorrectly states that IV insulin will be stopped once blood glucose reaches 150 mg/dL; typically, insulin continues until the blood glucose is at a safe level, and fluid replacement is ongoing.
- The third option is not in line with current practice; IV insulin is preferred in the acute management of HHS.
- The fourth option is inaccurate because oral fluid administration is inadequate and inappropriate in the acute setting of HHS where patients are often severely dehydrated and may not be able to tolerate oral intake.
Thus, the first option is the best choice regarding the treatment of HHS.