A patient with hyperosmolar hyperglycaemic state is confused, has very dry mucous membranes and a blood pressure of 90/58 mmHg. Which prescribed therapy should the nurse prioritise after establishing intravenous access?
Correct answer: A. Intravenous isotonic fluid replacement
- A. Intravenous isotonic fluid replacement
- B. Oral rapid-acting carbohydrate
- C. Subcutaneous long-acting insulin only
- D. Fluid restriction to prevent cerebral oedema
Explanation
Severe dehydration and reduced circulating volume are major problems in hyperosmolar hyperglycaemic state, so isotonic intravenous fluid replacement is prioritised. Oral carbohydrate worsens hyperglycaemia, while fluid restriction increases circulatory compromise.
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About Endocrine and Diabetes Nursing
Covers diabetes mellitus, insulin therapy, hypoglycaemia, diabetic ketoacidosis, hyperosmolar states and common thyroid, adrenal and pituitary disorders. It includes blood glucose monitoring, diet, foot care, sick-day management and the clinical differences between type 1 and type 2 diabetes and between diabetic ketoacidosis and hyperosmolar hyperglycaemic state.
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