Question

A 22-year-old woman presents with polyuria, polydipsia, and weight loss. Her random plasma glucose is 18.2 mmol/L, and capillary ketones are high. Venous blood gas shows pH 7.21 and bicarbonate 13 mmol/L. What is the most appropriate initial fluid management?

Accepted Answer

Give 1-1.5 L of isotonic saline in the first hour

Answer

Bolus 10 mL/kg of 5% dextrose in water

Answer

Start an insulin infusion before giving fluids

Answer

Administer half-normal saline (0.45%) at maintenance rates only

Answer

Restrict fluids to avoid cerebral oedema

Practice question

A 22-year-old woman presents with polyuria, polydipsia, and weight loss. Her random plasma glucose is 18.2 mmol/L, and capillary ketones are high. Venous blood gas shows pH 7.21 and bicarbonate 13 mmol/L. What is the most appropriate initial fluid management?