Need help locking down the differences between DKA & HHNS? We've got you! #nclex #nursingschool

Añadido: 2026-05-22

[00:00:00]The nurse continues with a physical assessment of a client and reviews the laboratory results. For each client finding, click to specify if the finding is diabetic ketoacidosis or hyperglycemic hyperosmolar state, so HHS, also called HHNS. And I'm looking at my patient orders and I can see those results here. And in the CMP, I have a low sodium, low potassium, high BUN and creatinine, and my glucose is very, very high, which I expected anyways cuz that's consistent with both DKA and HHS.

[00:00:31]The client has a 3-day history of generalized weakness, nausea, excessive thirst. They're alert and oriented, no pain. Lung sounds are clear, abdomen non-distended with normal active bowel sounds. Last bowel movement was yesterday. So, all of this so far seems normal. Mucous membranes dry, history of hypertension, hyperlipidemia with low blood pressure, heart rate high, respiratory rate 18, oxygenation 96% on room air, and then our temperature 98.6°.

[00:00:57]Type 1 diabetes. Think HHS, also HHNS.

[00:01:01]More initials versus three for DKA, so that's earlier in the numeric system as is type 1. So, the less letters in the initials, type 1, more type 2. Delirium or confusion, that can be present with the hyperglycemic hyperosmolar state.

[00:01:18]I'm pretty sure our patient is in an HHS if they are in DKA. How I know that is because if they were in a hyperosmolar state, I would see elevated hemoglobin and hematocrit levels. And also, my patient doesn't have confusion. They're alert and oriented times four. Fruity smelling breath, so that's going to be with our DKA diabetic ketoacidosis because that's a metabolic issue. And when we have metabolic issues and metabolic acidosis, our lungs are the ones that come and try to compensate and help out. And then finally, abnormal potassium levels. Does my patient have abnormal potassium levels? They sure do.

[00:01:53]That one I would feel confident in selecting. Also, DKA for the abnormal potassium levels since I'm pretty sure my patient has DKA.