Question

A 35-year-old with DKA presents with K⁺ 3.0 mEq/L, pH 7.12, glucose 520 mg/dL, anion gap 24. After initial isotonic fluids, what is the next step before insulin?

Accepted Answer

Administer 20-30 mEq K⁺ per hour until K⁺ ≥3.3 mEq/L, then start insulin

Answer

Start insulin infusion 0.1 U/kg/h immediately

Answer

Give sodium bicarbonate bolus, then insulin

Answer

Start dextrose-containing fluids now

Answer

No potassium replacement needed yet

Practice question

A 35-year-old with DKA presents with K⁺ 3.0 mEq/L, pH 7.12, glucose 520 mg/dL, anion gap 24. After initial isotonic fluids, what is the next step before insulin?