Diabetic Emergencies: Recognition And Treatment Practice Test

A 66-year-old man with type 2 diabetes is confused and very thirsty after 1 week of dysuria and fever. Vital signs: BP 88/52 mm Hg, HR 130/min, RR 20/min, T 38.6°C (101.5°F); glucose 920 mg/dL. Labs: serum osmolality 338 mOsm/kg (normal 275–295), pH 7.34 (normal 7.35–7.45), HCO3− 20 mEq/L (normal 22–26), serum ketones trace (normal negative). What is the nurse’s PRIORITY intervention for this patient with a mixed presentation?

A 72-year-old man with type 2 diabetes is being treated for HHS. Vital signs: BP 100/64 mm Hg, HR 110/min, RR 18/min, T 37.9°C (100.2°F); glucose 760 mg/dL. Labs: serum osmolality 330 mOsm/kg (normal 275–295), pH 7.40 (normal 7.35–7.45), HCO3− 24 mEq/L (normal 22–26), serum ketones negative (normal negative). Which assessment finding indicates HHS rather than DKA in this patient?