Moderate to high rates of infusion (200 to 500 mL/hour) may continue for several
more hours. Although the initial plasma concentration of potassium may be low, normal, or
even high, There is a major loss of potassium from body stores and an intracellular-
to-extracellular shift of potassium. Furthermore, the serum level of potassium decreases as potassium reenters the cells
during the course of treatment of DKA; therefore, the serum potassium level must
be monitored frequently. IV fluid solutions with higher concentrations of glucose, such as normal saline (NS)
solution (eg, D 5 NS, D5.45NS), are administered when blood glucose levels reach
250 to 300 mg/dL (13.8 to 16.6 mmol/L), to avoid too rapid a drop in the blood
glucose level (ie, hypoglycemia) during treatment.Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)
- Is a serious condition most frequently seen in older persons.
- HHNS is usually brought on by something else, such as an illness or infection,
dialysis, drugs that increase BS. - Blood sugar levels rise resulting into glycosuria, polyuria, thirst.
- Severe dehydration will lead to seizures, coma and eventually death.
- HHNS may take days or even weeks to develop. Know the warning signs of HHNS.
HHNS/ clinical manifestations
Hypotension, profound dehydration (dry mucous membranes, poor skin turgor),
tachycardia, and variable neurologic signs (eg, alteration of sensorium, seizures,
hemiparesis).
- Blood glucose level (600 to 1200 mg/dL)
- Treatment: fluid replacement, correction of electrolyte imbalances, and insulin.