Question

A 45-year-old woman with type 1 diabetes presents with nausea, abdominal pain, Kussmaul respirations, and altered mentation. Labs: glucose 462 mg/dL, pH 7.12, bicarbonate 9 mEq/L, anion gap 26, serum potassium 2.9 mEq/L, creatinine 1.1 mg/dL. What is the most appropriate immediate management step?

Accepted Answer

Administer IV potassium first and withhold insulin until K is >=3.3 mEq/L

Answer

Start IV regular insulin infusion 0.1 units/kg/h now

Answer

Give 2 L lactated Ringer's then start insulin infusion

Answer

Give sodium bicarbonate infusion until pH >=7.30

Answer

Start subcutaneous rapid-acting insulin every hour

Practice question

A 45-year-old woman with type 1 diabetes presents with nausea, abdominal pain, Kussmaul respirations, and altered mentation. Labs: glucose 462 mg/dL, pH 7.12, bicarbonate 9 mEq/L, anion gap 26, serum potassium 2.9 mEq/L, creatinine 1.1 mg/dL. What is the most appropriate immediate management step?