Question

A diabetic patient has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. After assessment of the patient, you suspect DKA rather than HHS based on the finding of

A. polyuria.
B. severe dehydration.
C. rapid, deep respirations.
D. decreased serum potassium.

Answer 1

Rapid, deep respirations are a key sign that suggests a diabetic patient with unresponsiveness and high blood glucose levels is experiencing Diabetic Ketoacidosis (DKA) rather than Hyperosmolar Hyperglycemic State (HHS).

Step-by-step explanation:

A diabetic patient with a serum glucose level of 824 mg/dL (45.7 mmol/L) and unresponsiveness might be experiencing a severe hyperglycemic crisis, which can be either Diabetic Ketoacidosis (DKA) or Hyperosmolar Hyperglycemic State (HHS). One key clinical finding that suggests DKA rather than HHS is the presence of rapid, deep respirations, also known as Kussmaul breathing. This is a compensatory mechanism for the metabolic acidosis caused by the overproduction of ketone bodies in DKA. This contrasts with HHS, where such pronounced breathing patterns are usually not present, as there is less ketone production in HHS.

Additionally, while both conditions may present with polyuria (excessive urination) and severe dehydration due to the diuretic effect of high blood glucose levels, these symptoms are not as specific to DKA. The possible finding of decreased serum potassium could be present in both conditions but is not definitive alone for distinguishing DKA from HHS.