Nonketotic hyperosmolar coma

Hepatic encephalopathy Hyperbilirubinemia Hypocalcemia Hypercalcemia Hyperparathyroidism Hypoparathyroidism Thiamine deficiency (Wernicke s) encephalopathy Diabetic ketoacidosis Nonketotic hyperosmolar coma Phosphate depletion Hypoglycemia Hypoxemia Hypercapnia... 

When a 45-year-old man with severe lithium-induced diabetes insipidus developed hyperosmolar, nonketotic hyperglycemia, it was suggested that poorly controlled diabetes mellitus may have contributed to the polyuria (684). Prior contact with a female patient who had developed hyperosmolar coma secondary to lithium-induced diabetes insipidus (685) allowed physicians 4 years later to treat her safely after a drug overdose and a surgical procedure, by avoiding intravenous replacement fluids with a high dextrose content (despite stopping lithium several years earlier, the patient continued to put out 10 liters of urine daily) (686). 

Oakley DE, Ellis PP. Glycerol and hyperosmolar nonketotic coma. Am J Ophthalmol 1976 81(4) 469-72. 

Azam H, Newton RW, Morris AD, Thompson CJ. Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus. Postgrad Med J 1998 74(867) 39 11. 

When hyperglycemic coma occurs it is almost always of the hyperosmolar nonketotic type. After termination... 

In diabetic ketoacidosis, hyperosmolar nonketotic coma, and hypoglycemia, the clinical laboratory has an essential role in both diagnosis and monitoring of therapy Several analytes are frequently measured to guide clinicians in treatment regimens to restore euglycemia and correct other metabolic disturbances. The metabolic abnormalities of these conditions are beyond the scope of this book, and interested readers are referred to a standard textbook of medicine. The NACB guidelines also provide information on the tests that are used. 

Features Diabetic ketoacidosis (OKA) Hyperosmolar nonketotic coma (HONK) Lactic acidosis... 

Assess the client for hyperosmolar, hyperglycemic, nonketotic coma. 

A client with Type 1 diabetes will experience diabetic ketoacidosis a client with Type 2 diabetes will experience hyperosmolar, hyperglycemic, nonketotic coma. 

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