Stage 6 — Evaluate outcomes. Review the metabolic trend and answer both questions.
Trend
Choose your responses, then check the answer.
Explanation
Falling beta-hydroxybutyrate with recovery of pH and bicarbonate indicates DKA resolution. Glucose may normalize earlier, so insulin continues with dextrose as needed. Basal subcutaneous insulin must overlap the intravenous infusion to reduce rebound ketoacidosis.
Quick answer The ketone and acid-base trend shows resolution; overlap basal insulin before stopping the infusion.
Why this is correct DKA resolution depends on ketone clearance and correction of acidosis, not glucose alone. A planned insulin overlap prevents an insulin-free interval and rebound ketogenesis.
Easy analogy or mental picture The intravenous and basal insulin courses should overlap like two bridge sections. Removing the first before the second is in place leaves a gap.
Memory hook Close ketones, correct acid, overlap insulin.
NCLEX decision rule Evaluate DKA with metabolic endpoints and ensure basal coverage before discontinuing intravenous insulin.
Why the other choices are wrong Glucose can fall before DKA resolves, oxygen saturation is not a metabolic endpoint, and an uninspected pump or delayed basal plan can recreate the original insulin gap.
References
1Hyperglycemic Crises in Adults With Diabetes: A Consensus ReportDKA diagnosis, fluids, insulin, potassium, dextrose, monitoring, resolution, and transition
Case updateFluids, potassium replacement, and intravenous insulin were administered according to protocol. The team is evaluating resolution and transition.