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.

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Last updated: May 3, 2010