A client with diabetic ketoacidosis has a serum potassium of 3.1 mEq/L before the insulin infusion is started. Which action should the nurse anticipate?
1Start the insulin infusion immediately without additional orders.
2Restrict all IV fluids until the potassium is normal.
3Give sodium polystyrene sulfonate to lower the potassium.
4Replace potassium as prescribed before or with insulin therapy.✓ Correct answer
Explanation
Insulin shifts potassium into cells and can worsen hypokalemia. In diabetic ketoacidosis, low potassium must be corrected according to protocol before or with insulin therapy to reduce dysrhythmia risk. Potassium-lowering therapy or fluid restriction would be unsafe in this cue pattern.
Clinical Judgment Use the client cues, timing, labs, and safety risks to select the response that best fits DKA with low potassium.
Memory Tip Match the strongest cue cluster to the safest nursing judgment.
KR vs US NCLEX items reward cue-based priority thinking rather than isolated recall.
Clinical Practice GuideFor DKA with low potassium, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.
CautionDo not choose an action from one isolated cue when the full scenario changes priority or safety.
Diabetic Ketoacidosis — A hyperglycemic emergency with ketosis, dehydration, and metabolic acidosis.
Hypokalemia — Low serum potassium that can cause muscle weakness and dysrhythmias.
Insulin Infusion — Continuous IV insulin used to treat severe hyperglycemia and ketoacidosis.