A patient with diabetic ketoacidosis is receiving intravenous insulin. The serum potassium level falls to 3.0 mEq/L (3.0 mmol/L). Which action is most appropriate?

Correct answer: C. Notify the provider and anticipate potassium replacement

  • A. Continue insulin and restrict potassium intake
  • B. Stop all fluids and encourage oral water
  • C. Notify the provider and anticipate potassium replacement
  • D. Give sodium bicarbonate before checking the ECG

Explanation

Insulin moves potassium into cells and can cause dangerous hypokalaemia during DKA treatment. The nurse should report the low level and anticipate potassium replacement, with cardiac monitoring as indicated, before continuing insulin according to the protocol.

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About Endocrine and Diabetes Nursing

Covers diabetes mellitus, insulin therapy, hypoglycaemia, diabetic ketoacidosis, hyperosmolar states and common thyroid, adrenal and pituitary disorders. It includes blood glucose monitoring, diet, foot care, sick-day management and the clinical differences between type 1 and type 2 diabetes and between diabetic ketoacidosis and hyperosmolar hyperglycaemic state.

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