A patient was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, K+ is 3.7 mEq/L, and pH is 7.10 . Which of the following interventions would you expect? (Select all that apply.)
a. NS 1.5 L IV fluid bolus
b. Insulin infusion at 5 units/hr
c. Sodium bicarbonate 50 mmol IV push
d. Vasopressin 10 units IM every 3 hr
e. Potassium 20 mEq/L of IV fluid
A, B, E
Dehydration is a common presenting issue in DKA, so the administration of fluids and insulin will help correct the hyperglycemia and acidosis. Sodium bicarbonate is not recommended unless the pH is less than 6.9 . As dehydration is reversed, potassium moves back into the cells, and hypokalemia can result, so administration of replacement potassium is necessary.
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