A 25 year-old female with altered mental status and fruity breath has been brought into the ER. You know this patient is likely in Diabetic Ketoacidosis (DKA), which interventions will be included in the treatment of this patient? Select all that apply

 

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Correct

- Starting an IV

- Giving IV fluids

- Administering IV insulin

- Getting ECG

- Getting a POC glucose

Rationale

These patients are going to be a hard stick because they have very viscous blood. The number one priority is getting an IV followed by giving fluids. A POC glucose is also vital information. You will not be giving subQ insulin, you will be giving IV insulin because the level of insulin that needs to be given, needs to be given continuously. Also, insulin pulls glucose across the cell membrane. as well as potassium (think cardiac arrhythmia). This patient is going to be acidotic, and managing their pH and potassium is directly related, meaning for every 0.1 unit of pH there will be a 0.6 mEq/L in serum plasma potassium. So wait for your pharmacist, doctor and lab to calculate the best rate and amount for this patient while you are giving them fluids. Also, Getting an ECG is pretty important because the potassium and other electrolytes are likely out of balance.

References:

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NCLEX Category

Management of Care

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Question ID - 368905

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