Progressive Care Nursing Certification (PCCN) Practice Exam

In hyperosmolar hyperglycemic syndrome (HHS), what should the nurse do before administering insulin?

1. Check the patient's potassium level

2. Monitor the heart rate

3. Monitor the patient's level of pain

4. No precautions are necessary

The correct answer is: Check the patient's potassium level

In hyperosmolar hyperglycemic syndrome (HHS), checking the patient's potassium level is crucial before administering insulin. Insulin lowers blood glucose levels by facilitating the uptake of glucose into cells, but it also drives potassium into the cells, which can lead to hypokalemia (low potassium levels) if the levels are already low. If a patient with HHS has hypokalemia, administering insulin without correcting the potassium imbalance can result in severe cardiac complications, including arrhythmias. Therefore, monitoring and potentially replacing potassium is an essential step in the management of HHS prior to insulin administration. This ensures patient safety and supports proper management of their electrolyte status during treatment.