Question

A 28-year-old presents with DKA: glucose 520 mg/dL, pH 7.12, HCO₃⁻ 10 mEq/L, anion gap 24, K⁺ 3.0 mEq/L. What is the best immediate next step before starting insulin?

Accepted Answer

Give IV potassium chloride to raise K⁺ >3.3 mEq/L, then start insulin

Answer

Begin IV regular insulin infusion at 0.1 U/kg/h immediately

Answer

Give IV sodium bicarbonate

Answer

Start subcutaneous rapid-acting insulin every 2 hours

Answer

Give IV mannitol

Practice question

A 28-year-old presents with DKA: glucose 520 mg/dL, pH 7.12, HCO₃⁻ 10 mEq/L, anion gap 24, K⁺ 3.0 mEq/L. What is the best immediate next step before starting insulin?