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Clinical - Hyperosmolar Hyperglycaemic Syndrome - Case Study Example

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Clinical - Hyperosmolar Hyperglycaemic Syndrome

She was accompanied by her daughter. Mrs. L had a three-day history of confusion, lethargy and drowsiness. She complained of thirst for the last one week, drinking more than eight pints of water a day. Upon registration at the ambulance registration desk of the Emergency Department by administrators, Mrs. L was placed in a separate room, within the department for exceptional care. She was intubated and ventilated because of hypoxemia and poor conscious level, after which her fracture was attended to. Examination showed that the patient had a heart rate of 130, body temperature of 38.2 degrees Celsius, blood pressure of 150/80 and fair chest excursion, with loose wheezes, and serum pH of 7.5. Mrs. L was also dehydrated, as evidenced by her dry mucous membranes. Mrs. L’s spO2 reading was 80%. A blood sample was taken for checking. After the Doctor’s check ups, Mrs. L’s blood glucose was diagnosed with excess of 56. 5mmol. Therefore, her blood glucose was elevated. Tests involving Mrs. L’s urine were positive for glucose; however, she took long to pass urine. She was transferred to the resuscitation room to receive specialised care because she was categorised as having life-threatening conditions and injuries. After investigation from her close family member, the accompanying daughter, it was revealed that Mrs. L had fallen while she at the bathroom. That is why she had a fracture femur. Her family history was also significant for diabetes and hypertension. Clinical Manifestations Dehydration Dehydration is the insufficiency in the amount of water in the human body. It is prudent to identify and treat dehydration early enough to prevent further complications (Konrad, Corrigan, Hamilton, Steiger, & Kirby, 2013). This is because mild dehydration is known to cause tension and fatigue (Ganio & Armstrong, 2011). It can also cause lack of focus, according to (Szalavitz), 2012. It was established from clinical tests that Mrs. L had dry lips and was dizzy, as well as, confused. Mrs. L also had dry mucous membranes. This was enough evidence that the patient was dehydrated. Most of the patients who are dehydrated are normally confused, dizzy, with dry lips and mucous membranes (Campbell, 2011) and (Heit, 2013). It was found out that the patient had complained of thirst for the previous one week, drinking more than eight pints of water a day, from the history of Mrs. L, provided by her daughter. It is healthy to drink lots of water but excessive thirst, and the frequent urge to drink too much water, exhibited by Mrs. L was a sign of dehydration. Finally, the fact that it took long for the patient to pass urine that was required for urine tests was a sign of dehydration. Hyperosomar Hyperglycaemia Syndrome is characterised by hyperglycaemia, extreme dehydration and hyperosmolar plasma (Balasubramaniyam, Palanis, & Rajamani, 2011). Hyperosomar Hyperglycaemia Syndrome is characterised by severe hyperglycaemia. This is a marked increase in serum osmolality and clinical evidence of dehydration, without the accumulation of acetoacetic ketoacids (Venkatraman & Singhi, 2006). Hyperglycaemia results from either an absolute or relative insulin deficiency. It ca also be a result of decreased tissue responsiveness to insulin, which is an increased insulin resistance. This results into gluconeogenesis and glycogenolysis, leading into a reduced rate of glucose uptake and utilization by peripheral tissues. A rise in ...Show more


Hyperosomar Hyperglycaemia Syndrome (Name) (Institution) Introduction Hyperosomar Hyperglycaemia Syndrome is a condition in which a patient’s blood-glucose level is very high, but ketones are not present in the patient’s urine or blood (The Healthy Living Magazine, 2013)…
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