A client with diabetic ketoacidosis is prescribed IV insulin… | MyMerci
Illness ManagementPA
Question
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?
1Start insulin immediately because potassium will rise.
2Replace potassium as prescribed and place the client on cardiac monitoring.✓ Correct answer
3Give oral glucose and discharge the client.
4Restrict all IV fluids until potassium is normal.
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.
In-depth explanation
Clinical Judgment In DKA, insulin treats acidosis but can make low potassium dangerous.
Memory Tip Check potassium before insulin.
Clinical scenario
Clinical Practice Guide DKA management includes fluids, insulin, potassium monitoring and replacement, glucose trends, and acid-base correction.
Caution Hypokalemia can become life-threatening when insulin is started.
Key concepts
Diabetic Ketoacidosis — A serious diabetic emergency involving hyperglycemia, ketosis, and acidosis.
Hypokalemia — A low serum potassium level that can cause muscle weakness and dysrhythmias.
Insulin Infusion — Continuous IV insulin therapy used in selected hyperglycemic emergencies.