A male client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase).
- a- Serum potassium level
- b- Serum sodium level
- c- Arterial blood gas (ABG) values
- d- Serum osmolarity
Answer D.
Serum osmolarity is the most important test for confirming HHNS; it’s also used to guide treatment strategies and determine evaluation criteria.A client with HHNS typically has a serum osmolarity of more than 350 mOsm/L. Serum potassium, serum sodium, and ABG values are also measured, but they aren’t as important as serum osmolarity for confirming a diagnosis of HHNS. A client with HHNS typically has hypernatremia and osmotic diuresis. ABG values reveal acidosis, and the potassium level is variable.
d- Serum osmolarity:
The most important laboratory test for confirming hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is d- Serum osmolarity.
HHNS is a serious complication of diabetes that occurs when blood sugar levels are extremely high (over 600 mg/dL) and the blood becomes very concentrated (hyperosmolar). This can lead to dehydration, electrolyte imbalances, and coma.
Serum osmolarity measures the total number of dissolved particles in the blood, including glucose, electrolytes, and proteins. A high serum osmolarity is a key diagnostic feature of HHNS.
The other answer choices are not as important for confirming HHNS:
- Serum potassium level:
Hyperkalemia (high potassium levels) can occur in HHNS, but it is not a specific diagnostic feature of the disorder.
- Serum sodium level:
Hypernatremia (high sodium levels) can also occur in HHNS, but it is not as common as hyperosmolarity.
- Arterial blood gas (ABG) values:
ABG values can be abnormal in HHNS, but they are not as specific for the disorder as serum osmolarity.
Therefore, the most important laboratory test for confirming HHNS is serum osmolarity.
