Hyperosmolar Hyperglycemic State (HHS): NCLEX Priorities
HHS: profound hyperglycemia, dehydration, no/minimal ketones, slow correction.
HHS is the T2 cousin of DKA. NCLEX tests recognition and management differences.
Recognition
BG often >600. Minimal/no ketones. pH normal. Profound dehydration. Altered mental status. Usually T2DM.
Treatment
Aggressive IV fluid (NS). Insulin drip but less aggressive than DKA. K+ replacement. Treat precipitant (infection most common).
Correct slowly
Mortality higher than DKA. Cerebral edema risk with rapid correction. Drop BG no more than 50-75 mg/dL/h.
Frequently asked
Why HHS more dangerous than DKA?
Older patients, more comorbidities, slower presentation, more severe dehydration.
Common precipitants?
Infection, MI, stroke, non-adherence to meds.
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