Question

A 27-year-old with type 1 diabetes presents with DKA: glucose 498 mg/dL, pH 7.12, bicarbonate 9 mEq/L, anion gap 24, serum K+ 2.9 mEq/L. After starting fluids, what is the next best step?

Accepted Answer

Hold insulin and give potassium until K+ ≥3.3 mEq/L.

Answer

Begin insulin infusion 0.1 units/kg/hr immediately.

Answer

Give sodium bicarbonate infusion.

Answer

Start insulin bolus 0.1 units/kg then infusion.

Answer

Administer calcium gluconate.

Practice question

A 27-year-old with type 1 diabetes presents with DKA: glucose 498 mg/dL, pH 7.12, bicarbonate 9 mEq/L, anion gap 24, serum K+ 2.9 mEq/L. After starting fluids, what is the next best step?