Hyperosmolar nonketotic diabetic coma in the rescue and care with.docVIP

 PAGE \* MERGEFORMAT 10 Hyperosmolar nonketotic diabetic coma in the rescue and care with [Keywords:] hyperosmolar nonketotic diabetic coma Nursing care Hyperosmolar nonketotic diabetic coma (HNDC is a rare severe diabetes, acute complications, high blood sugar, high sodium, high plasma osmotic pressure, characterized by severe dehydration, no significant ketoacidosis performance, patients often different levels of consciousness or coma, high mortality, up to 40% to 70% [1], in recent years, with the diagnosis and treatment of the continuous improvement of the dynamic observation of care, mortality decreased significantly, now in our hospital in 1997 to 2007 11 patients were treated HNDC Nursing of patients are summarized below. Clinical data 1. General Information 11 patients were admitted to our hospital in recent years, HNDC patients, 7 males and 4 females, aged 42 to 75 years, mean 60.9 years, 60 years old in 6 cases, 4 cases no history of diabetes, 7 patients had 1 5-year history of diabetes, all patients were found HNDC diagnostic criteria [2]. hospitalized 1 month before the 0 to a different degree of thirst, urinary symptoms or the symptoms get worse, and loss of appetite or anorexia associated with the phenomenon of 8 cases All patients had various degrees of consciousness and dehydration symptoms. 2. Laboratory The patients blood glucose levels 34.6 ~ 65.9 mmol / L, serum Na +138.4 ~ 179.2 mmol / L, plasma osmolality 376.90 ~ 440.18 mmol / L, BUN 9.45 ~ 61.20 mmol / L, pH value of 6.90 ~ 7.41, Ketone (+2 cases. 3. Results The group of 11 patients, 8 patients survived and 3 died, 1 patient died within 12 h of admission, and the other 2 patients died of heart and lung failure, mortality rate was 27.27%. Rescue with 1. Fluids Rehydration immediately after diagnosis, and actively correct the hyperosmolar state, the establishment of two venous access, one for intravenous infusion, and the other one for insulin infusion,