DKA and HHS (HHNS) nursing NCLEX lecture review of the treatment, patient signs/symptoms, and management. Diabetic ketoacidosis and hyperosmolar hyperglycemia nonketotic syndrome are two complications that can present in diabetes mellitus. DKA is more common in type 1 diabetics, whereas, HHNS is more common in type 2 diabetics. Patients with diabetic ketoacidosis will present with ketosis and acidosis and signs/symptoms will include hyperglycemia (greater than 300 mg/dL), Kussmaul breathing, fruity (acetone breath), ketones in the urine, and metabolic acidosis. Patients with hyperglycemic hyperosmolar syndrome will NOT have ketosis or acidosis but EXTREME hyperglycemia (greater than 600 mg/dL). In addition, hyperosmolarity will present which will cause major osmotic diuresis and the patient will experience with severe dehydration.

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