What is the treatment approach for HHNK?

The treatment approach for Hyperglycemic Hyperosmolar Nonketotic (HHNK) state primarily focuses on rehydration; therefore, the correct answer emphasizes rehydrating without insulin in the solution. The rationale behind this is that patients with HHNK often present with extreme dehydration and elevated blood glucose levels, but they typically do not exhibit ketoacidosis, which distinguishes them from patients with diabetic ketoacidosis (DKA).

In this scenario, the primary goal is to restore the patient's fluid volume and electrolyte balance, addressing hyperosmolarity and preventing complications associated with dehydration. Once the patient is adequately rehydrated, regular monitoring of blood glucose levels will guide the need for insulin administration, which is often introduced after ensuring sufficient fluid resuscitation.

Other treatment options listed do not align with the appropriate management of HHNK. Oral glucose monitoring and immediate IV glucagon administration are not indicated in this context. While continuous glucose monitoring may be important for overall management of diabetes, it does not directly treat the hyperglycemic state. IV glucagon is typically used in cases of severe hypoglycemia, not hyperglycemia, which further clarifies the choice of treatment for HHNK.