A 44-year-old patient with type 1 diabetes is brought to the emergency department with ketoacidosis. The nurse should immediately prepare to administer
a. subcutaneous insulin.
b. intravenous normal saline in large quantities.
c. dextrose 50% plus thiamine.
d. glucagon.
B
DKA is marked by hemoconcentration and shock in addition to ketoacidosis. Therefore, treat-ment is directed at restoring acceptable plasma glucose levels, correcting acidosis, replacing lost water and sodium, and normalizing potassium levels. IV fluids and electrolyte therapy are started first, and insulin administration is begun as soon as practical afterward. IV saline, therefore, is the first treatment for DKA.
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