Question

A 50-year-old woman with A1c 9.8% has abdominal pain, nausea, Kussmaul respirations. Labs: glucose 392 mg/dL, pH 7.12, bicarbonate 10 mEq/L, anion gap 24, K+ 3.0 mEq/L. Next best step before starting insulin infusion?

Accepted Answer

Replete potassium until K+ >3.3 mEq/L

Answer

Start insulin infusion 0.1 U/kg/h immediately

Answer

Start sodium bicarbonate infusion

Answer

Give subcutaneous insulin only

Answer

No fluids until potassium is corrected

Practice question

A 50-year-old woman with A1c 9.8% has abdominal pain, nausea, Kussmaul respirations. Labs: glucose 392 mg/dL, pH 7.12, bicarbonate 10 mEq/L, anion gap 24, K+ 3.0 mEq/L. Next best step before starting insulin infusion?