Diabetic Ketoacidosis vs. Hyperosmolar Hyperglycemic Syndrome: Similarities (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Nursing DKA vs HHS.pdf
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      Review Sheet Hyper vs Hypoglycemia Nursing.pdf
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      Reference List Medical Surgical Nursing and Pathophysiology Nursing.pdf
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    00:01 Hi! Welcome to our video series on diabetes and severe hyperglycemia.

    00:07 Hey, do me a favor. I want to focus you right from the start.

    00:10 So underline or circle, whatever your style is the word 'severe'.

    00:15 Because I want you to know that's what we're talking about.

    00:18 Now I'm going to refer to them as DKA and HHS, why? Because it's going to be a lot longer video if every time I'm talking about DKA, I say, diabetic ketoacidosis or when I'm talking about HHS I say, hyperosmolar hyperglycemic syndrome.

    00:37 So we're going to call them DKA and HHS moving forward.

    00:42 Now there's not a lot on this slide because I want your brains clear to focus.

    00:47 DKA and HHS do have some things in common.

    00:51 But one happens predominately in type ones and one happens predominately in diabetic clients who have type 2 diabetes.

    00:59 So go ahead and Right in on your notes above DKA write in type 1, above HHS write type 2.

    01:10 Okay so we started, we know we're talking about severely high blood sugar.

    01:15 We know we have DKA and HHS and which one happens in type 1 diabetics which one happens more often in type 2 diabetics.

    01:24 Now, there are four specific things I want you to think about.

    01:26 So we're just talking big picture.

    01:29 They have four things that both DKA and HHS have in common.

    01:34 I'll explain more about it later in the video series.

    01:36 So don't get really wrapped up in details.

    01:39 I just want you to have this framework as we're starting out.

    01:42 So the first thing is both DKA and HHS happen in diabetic patients, you have that solid because you've already written in type 1 and type 2 in your notes.

    01:54 Let's look at the second thing.

    01:56 DKA and HHS both represent life threatening medical emergencies.

    02:03 That's how high or severely elevated their blood glucose is.

    02:07 So both DKA and HHS can become life-threatening medical emergencies.

    02:13 The third one might kind of remind you of chemistry, but both show increased serum plasma osmolarity because they end up being really dehydrated.

    02:24 Keep in mind the normal serum osmolarity is 275 to 295.

    02:30 Now, it's made this osmotic effect because of the serum sodium, the potassium, the glucose and urea.

    02:38 So when we're talking about serum osmolarity we're talking about the density how much of that substance is in your blood as compared to the liquid portion.

    02:48 Now, the fourth one is extreme osmotic diuresis and dehydration.

    02:53 See number three and number four go together, but let me walk through that list again, you got to be diabetic for this to happen, because diabetic clients have really high blood glucose is when they have DKA or HHS.

    03:08 When you have an elevated glucose, you also have an increased serum plasma osmolarity, good your tracking with me.

    03:16 And that's why you end up with this extreme osmotic diuresis and dehydration.

    03:22 Why? That bloodstream is now full of a ton of glucose.

    03:28 That's what's raising that plasma osmolarity.

    03:31 As the osmolarity numbers are going higher that means the water concentration is getting lower because the body is dumping water into that intravascular space like crazy to try to delete that concentration.

    03:44 However, when you put all that in intravascular space, the patient is going to pee it all out and that's why they end up so dehydrated.

    03:52 So I don't want to go through this slide too quickly.

    03:54 Remember it's important that you understand the similarities between both of these later on we're going to talk talk about the differences.

    04:01 So they're diabetic, they have really high blood sugars, their serum osmolarity goes up which leads to extreme osmotic diuresis and eventual dehydration.

    About the Lecture

    The lecture Diabetic Ketoacidosis vs. Hyperosmolar Hyperglycemic Syndrome: Similarities (Nursing) by Rhonda Lawes, PhD, RN is from the course Diabetes Type 1 and 2: Complications and Symptoms (Nursing).

    Included Quiz Questions

    1. 350 mOsm/L
    2. 250 mOsm/L
    3. 278 mOsm/L
    4. 290 mOsm/L
    1. Polyuria
    2. Ketones in urine
    3. Peripheral edema
    4. Blurry vision

    Author of lecture Diabetic Ketoacidosis vs. Hyperosmolar Hyperglycemic Syndrome: Similarities (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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