32. A client with diabetic ketoacidosis has been treated with an insulin drip for the past 3 hours. For which imbalance is this client at greatest risk?
32. A client with diabetic ketoacidosis has been treated with an insulin drip for the past 3 hours. For which imbalance is this client at greatest risk?
Test-Taking Tip
The question asks for the "greatest risk." Hypoglycemia is too obvious. Think about the effects of insulin on K+.
Content Area: Adult Health, Endocrine; Integrated Process: Nursing Process, Analysis; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Fluid and Electrolyte Imbalances
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Answer 1 is incorrect because treatment will include as much as 6 to 10 L of normal saline for 2 to 3 hours. The infusion rate will be slowed to prevent hypervolemia. Answer 2 is correct because rehydration and the administration of insulin will cause the potassium to move back into the cells, resulting in a potentially even lower K+ level. Potassium replacement begins when the K+ level drops to normal to prevent hypokalemia. Answer 3 is incorrect because normal saline is the solution of choice during rehydration. Answer 4 is incorrect because the most immediate risk is the rapid drop of potassium as the electrolyte moves back into the cell as a result of rehydration and the insulin drip.
