A 28-year-old with type 1 diabetes presents with abdominal pain, Kussmaul respirations, and glucose 420 mg/dL. Labs: pH 7.18, HCO3− 10 mEq/L, anion ga...

Question

A 28-year-old with type 1 diabetes presents with abdominal pain, Kussmaul respirations, and glucose 420 mg/dL. Labs: pH 7.18, HCO3− 10 mEq/L, anion gap 24, serum potassium 3.0 mEq/L. After a 1 L bolus of 0.9% saline, what is the next best step?

Accepted Answer

Administer 40 mEq potassium chloride IV and delay insulin until K+ ≥3.3 mEq/L

Answer

Start IV insulin infusion at 0.1 units/kg/hour immediately

Answer

Give 20 mEq KCl only if potassium falls below 3.0 mEq/L

Answer

Start bicarbonate infusion

Answer

Switch to D5½NS now

us-abfm MCQ (SBA): DKA

A 28-year-old with type 1 diabetes presents with abdominal pain, Kussmaul respirations, and glucose 420 mg/dL. Labs: pH 7.18, HCO3− 10 mEq/L, anion gap 24, serum potassium 3.0 mEq/L. After a 1 L bolus of 0.9% saline, what is the next best step?