Journal of the American Association of Nurse Practitioners
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J Am Assoc Nurse Pract · Nov 2014
Case ReportsA case of a patient with hyperosmolar hyperglycemic state: implications for nurse practitioners in primary care.
The purpose of this case study is twofold: first, to present the pathophysiology of hyperosmolar hyperglycemic state (HHS) as it relates to a hospitalized patient with undiagnosed diabetes; the second is to increase awareness among primary care nurse practitioners (NPs) about the complexities of diagnosing less typical forms of diabetes. The case illustrates how HHS can be life threatening, how it is differentiated from diabetic ketoacidosis (DKA), and how it is treated. The importance of closer surveillance of blood glucose in high-risk individuals is highlighted. ⋯ With improved understanding of the phenomena leading to glucose dysregulation, less typical forms of diabetes might be identified earlier and controlled. NPs in primary care are uniquely positioned to reduce the risk of hyperglycemic crises.