Which nursing intervention is appropriate for a client admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

In cases of hyperglycemic hyperosmolar nonketotic syndrome (HHNS), fluid replacement is a critical intervention. This condition often arises in patients with poorly controlled diabetes, leading to high levels of glucose in the blood, which in turn results in extreme dehydration due to osmotic diuresis. The body loses a significant amount of water and electrolytes as glucose spills into the urine, leading to increased urinary output and severe dehydration.

Administering fluid replacement serves to restore intravascular volume, dilute the hyperglycemia, and improve kidney perfusion, which is essential for excreting excess glucose. It helps to correct hyperosmolarity and restore fluid balance, which is vital for the patient’s overall recovery and stabilization.

While other interventions, such as providing oxygen and dietary teaching, may seem relevant in various contexts, they do not directly address the immediate complications and needs presented by HHNS. Encouraging carbohydrates is counterproductive in the setting of hyperglycemia, as it would only exacerbate the condition. Therefore, fluid replacement is the most effective and appropriate nursing intervention for addressing the severe dehydration and hyperglycemic state associated with HHNS.