Difficulty: Medium
Average Score: 77%
Simulated
An older adult client with type 2 diabetes mellitus presents to the emergency department (ED) with a respiratory infection. The nurse recognizes that the client is at risk for hyperosmolar hyperglycemic state (HHS) as a result of which process?
Correct answer
A
Rationale
Infection acts as a stressor, triggering counter-regulatory hormones (cortisol, glucagon, epinephrine) that raise blood glucose. In type 2 DM, this can precipitate HHS (severe hyperglycemia >600 mg/dL, hyperosmolarity, dehydration without significant ketoacidosis). Fever, elevated WBC, and antibiotics are present but not the primary mechanism driving HHS.