A client with diabetic ketoacidosis is prescribed IV insulin. The potassium level is 2.9 mEq/L. Which action should the nurse anticipate before starting the insulin infusion?
1Initiate insulin therapy promptly because it will shift potassium back into cells.
2Postpone intravenous fluid therapy until the potassium level is normalized.
3Start the IV insulin infusion without delay and monitor potassium levels closely.
4Replace potassium as prescribed and place the client on cardiac monitoring.✓ Correct answer
Explanation
Insulin shifts potassium into cells and can worsen hypokalemia, increasing dysrhythmia risk. A potassium level of 2.9 mEq/L requires replacement and monitoring before or with insulin according to protocol. DKA also requires fluids and close monitoring, not discharge.