Hyperosmolar Nonketotic Syndrome (HONK)

First Things First (assess & treat for the following)

• Determine if pt is hemodynamically stable and begin resuscitation ABCs if needed.
• Look for precipitating factors—infection, myocardial infarction, cerebrovascular accident, mesenteric ischemia, acute pancreatitis and use of medications such as steroids, thiazide diuretics, calcium-channel blockers, propranolol and phenytoin.
• Mortality can approach 15% compared to < 2% in DKA. Mortality is usually due to an underlying medical condition.