Clinical context An adult taking empagliflozin develops feve… | MyMerci
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Clinical context An adult taking empagliflozin develops fever, poor intake, vomiting, and deep rapid respirations during a urinary infection; glucose is 184 mg/dL, beta-hydroxybutyrate 5.2 mmol/L, bicarbonate 12 mEq/L, and venous pH 7.24, establishing euglycemic diabetic ketoacidosis. Place the medication and monitoring steps in the safest sequence.

Ordered Response

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Add prescribed dextrose as glucose declines so insulin can continue until ketonemia and acidosis resolve.
Treat the infectious precipitant and continue serial beta-hydroxybutyrate, pH, bicarbonate, electrolytes, renal, and clinical reassessment.
Hold empagliflozin, assess airway and circulation, establish monitoring, and obtain the immediate glucose, ketone, electrolyte, renal, and venous pH studies.
Begin authorized isotonic fluids and reassess perfusion, urine output, lung findings, and kidney function.
Verify potassium and start protocol-directed insulin when safe, with frequent glucose and potassium checks.
Explanation
The sequence ends the suspect exposure, assesses severity, restores perfusion, protects potassium during insulin therapy, adds dextrose before hypoglycemia interrupts ketone clearance, and closes the loop with precipitant treatment and serial outcomes.
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For study reference only. Always follow current clinical guidelines and your institution’s protocols.