Hyperglycemia

Definition

Hyperglycemia is an abnormal elevation of blood glucose, typically defined as fasting glucose greater than 126 mg/dL or random glucose greater than 200 mg/dL. Chronic hyperglycemia is the hallmark of diabetes mellitus.

Signs and Symptoms (3 P's)

• Polyuria (excess urination)
• Polydipsia (excess thirst)
• Polyphagia (excess hunger)
• Also: blurred vision, fatigue, weight loss, slow wound healing, recurrent infections

Acute Complications

• DKA (Type 1): Ketones, fruity breath, Kussmaul respirations, glucose 300 to 500+, pH less than 7.35.
• HHS (Type 2): Glucose greater than 600, severe dehydration, altered LOC, no ketones.

Nursing Interventions

IV insulin, aggressive fluid resuscitation (NS initially, then potentially 0.45% NS), potassium replacement (insulin drives K+ into cells), frequent glucose and electrolyte monitoring, such as treat underlying precipitant (infection, missed insulin). Transition to subcutaneous insulin when stable.

NCLEX Relevance

3 P's are classic cues. DKA vs HHS differentiation is high-yield.