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Ah the pleasures of Schadenfreude. I hope neither of you are nursing educators
I watched avenue Q too, I'm rather fond of the monster Internet song however. As a matter of fact, I am an educator. No schadenfreude intended, a push in the proper direction rather. Sometimes the obvious things are often overlooked.
Most anything that would/could cause a rise in blood glucose in a type 2 diabetic can lead to HHNKS, with an underlying infection being one of the most common.
1. Infection.
2. Kidney Disorders.
3. Myocardial infarction.
4. diuretics, steroids or beta blockers.
5. Emotional stress
6. Excessive alcohol use.
7. Chronic illness.
8. Bleeding ulcer.
9. Too little insulin or oral anti-diabetic agents or forgot to take medications
10. Recent surgery or other physiologic stressor
So, you would need to look at the CBC w/differential, ESR, blood culture results, UA (especially WBC, leukocyte esterase, nitrites, and specific gravity), BUN, creatinine, and H&H. You also need to take a careful history from the patient and family.
Hope that helped.
HenryHyde
7 Posts
What kind of labs should I be looking at do discern causes if I suspect HHNS?