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Unstable angina and hyperosmolar hypoglycaemic nontetotic syndrome - Case Study Example

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Of the five problems (Dehydration, Tachycardia, Decreased level of consciousness, Hyperglycemia, and Hyperkalemia), Hyperglycemia should be given first priority. Hyperglycemia is defined as a condition in whereby there is an excessive circulation of glucose in the blood. This…
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Unstable angina and hyperosmolar hypoglycaemic nontetotic syndrome
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Unstable angina and hyperosmolar hypoglycaemic nontetotic syndrome

Hyperglycemia can result into other complications such as ketoacidosis and hyperkalemia. Insulin deficiency results into a potassium shift from the intra-cellular to the extracellular space (Margassey & Bastani, 2001). This can also occur due to increased osmolality that accompanies hyperglycemia.
Therefore, by treating hyperglycemia, one will prevent worsening of the other three conditions. Insulin, infusion should be conducted first to deal with hyperglycemia. This will further result into the movement of potassium from the extra-cellular space to the intracellular space (Lehnardt & Kemper, 2011). Treatment of hyperglycemia will have an immediate impact on dehydration and decreased consciousness, and will stop worsening of Hyperkalemia and tachycardia by extension.
Hyperglycemia can be treated in different ways. Glucotrol can be used to stimulate the pancreas to release insulin. Acarbose can be used to block enzymatic action on carbohydrates, while metformin or pioglitazone can be used to increase tissue sensitivity to insulin (Ripsin, H, & Urban, 2009).
The goal tachycardia therapy should be to slow down the first heart rate. Several strategies might be used such as the Vagal maneuvers and medications. In practice, medications are offered when the vagal maneuvers fail. Patients can take flecainide or propafenone. Cardioversion can also be used in emergency situations (University of Michigan Health System, 2012).
Hyperkalemia should then be tackled. Examination of Hyperkalemia must be conducted in a systematic level and this should include cardiac function, in addition to the urinary tract, hydration status and neurological processes (Margassey & Bastani, 2001).
Normally, individualized therapeutic strategies should always be employed in the management of hyperkalemia. The management should be guided by the specific findings regarding the level of potassium in the blood. Treatment needs to be hurried up due to ... Read More
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