Difference between DKA and HHNS.

DKA.                               HHNS
mainly seen in        •mainly seen in
type 1DM..                   type 2DM.
•happen suddenly.     •happen gradually.
no insulin present.     •severe infection.
or unknown DM.         physiologic stress.
physiologic stress.
•young and newly
diagnosed clients.       •older adult.
main problem :
kussumal breathing.  •extreme
acitone breath.              hyperglycemia.
                                         severe dehydration.
blood glucose :
usually >250mg/dl.       •usually>600mg/dl.
arterial pH:
<7.3.                                 •normal
present.                           •absent.
serum osmolarity:
300 to 350 mOsm/L.      •average>350mOsm/L.
bicarbonate :
<15mEq/L.                       •normal.
BUN and creatinine
level:elevated.                 •elevated.
mortality rate :
<5%                                    •10to 40%
treatment :
i/v insulin, i/v fluid,        •rehydration,         
potassium and                  electrolyte.

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