Question

A 29-year-old with type 1 diabetes presents with DKA: glucose 420 mg/dL, pH 7.18, HCO₃⁻ 10 mEq/L, anion gap 24, serum K⁺ 2.9 mEq/L. What is the best next step before initiating insulin infusion?

Accepted Answer

Administer 40 mEq potassium chloride and recheck potassium

Answer

Start insulin infusion at 0.1 units/kg/h now

Answer

Give sodium bicarbonate infusion until pH >7.3

Answer

Start dextrose 5% in half-normal saline immediately

Answer

Restrict fluids to avoid cerebral edema

Practice question

A 29-year-old with type 1 diabetes presents with DKA: glucose 420 mg/dL, pH 7.18, HCO₃⁻ 10 mEq/L, anion gap 24, serum K⁺ 2.9 mEq/L. What is the best next step before initiating insulin infusion?