]> 2026-07-31T07:52:02+00:00 WBR0829 0 en Continuous infusion of intravenous regular insulin and isotonic 0.9% normal saline '''Incorrect'''-Since the patient’s serum potassium has gone below 5.3 mEq/L, potassium should be added to the continuous infusion of intravenous regular insulin and isotonic 0.9% normal saline. Continuous infusion of intravenous regular insulin and hypertonic D5 normal saline '''Incorrect'''-Hypertonic D5 normal saline should replace the isotonic normal saline only when blood glucose falls below 200 mg/dL. Continuous infusion of intravenous regular insulin, hypertonic D5 normal saline and potassium '''Incorrect'''-Hypertonic D5 normal saline should replace the isotonic normal saline only when blood glucose falls below 200 mg/dL. Continuous infusion of intravenous regular insulin, isotonic 0.9% normal saline and potassium '''Correct'''-The first line of management of diabetic ketoacidosis (DKA) is starting the patient on a continuous infusion of intravenous regular insulin and isotonic 0.9% normal saline. Potassium is supplemented when serum potassium falls below 5.3 mEq/L. Continuous infusion of intravenous regular insulin, isotonic 0.9% normal saline, potassium and sodium bicarbonate '''Incorrect'''-Sodium bicarbonate can be administered only when acidosis (<7) is accompanied by a severe (<5 mEq/L) fall in serum bicarbonate level and life threatening hyperkalemia. Otherwise, sodium bicarbonate infusion can lead to neurological deterioration, slowing of the rate of recovery of ketosis and post treatment alkalosis. Inpatient Facilities Emergency Room Vendhan Ramanujam A 28 year old African-American male presented to the emergency department with complaints of lethargy and vomiting for the past one day. He is a known type 1 diabetes mellitus patient. He had a gastrointestinal disturbance before two days following which he restricted his food intake and skipped his insulin doses. He also played soccer with his friends last evening. Physical examination revealed a confused, dehydrated, tachypneic male with vital signs like heart rate of 120 beats/min, blood pressure of 98/58 mmHg, respiratory rate of 35/minute and oral temperature of 37.2 C. A rapid finger glucose test revealed plasma glucose of 638 mg/dL, thus confirming diabetic ketoacidosis. He was started on 0.9% normal saline while waiting for the following laboratory tests<br> <br> Serum sodium: 130 mEq/L<br> Serum potassium: 5.2 mEq/L<br> Serum chloride: 87 mEq/L<br> Serum bicarbonate: 12 mEq/L<br> Serum BUN: 32 mg/dL<br> Serum creatinine: 1.5 mg/dL<br> Blood glucose: 700 mg/dL<br> Blood pH: 7.08<br> PaCO2: 25 mmHg<br> <br> Urinary Ketones turned out to be positive. Meanwhile he was transferred to the intensive care unit. What is the next best step in line of management of this patient? D Endocrine Electrolytes 2020-10-28T01:48:54Z 2459150.575625 WBR0829