Unstable angina and Hyperosmolar hypoglycaemic nontetotic syndrome
Question one Of the five problems (Dehydration, Tachycardia, Decreased level of consciousness, Hyperglycemia, and Hyperkalemia), Hyperglycemia should be given first priority.
Reduced levels of insulin make it hard for the body to convert glucose into glycogen resulting into excess levels in the blood (Hu, Pan, & Sun, 2012). 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. Hyperglycemia also results into dehydration as the body disposes excess glucose through urine leading to excessive water loss. The complication is also responsible for decreased consciousness. 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). ...