Endocrine Question #26


The nurse is caring for a client just admitted to the intensive care unit for diabetic ketoacidosis (DKA). Which three priority treatments are critical during diabetic ketoacidodis.


  1. Potassium replacement, insulin replacement, amiodorone therapy
    • Rationale:
  2. Fluid replacement, bicarb replacement, hypertonic saline infusion
    • Rationale:
  3. Fluid replacement, insulin therapy, and electrolyte correction
    • Rationale:
  4. Oral rinses, fluid replacement, bicarb replacement
    • Rationale:



Important treatments for DKA include fluid replacement to replace fluid deficit and it helps to decrease glucose plus will aid in renal function. Secondly, insulin therapy must be initiated; however, fluids need attention first, then insulin. Insulin may be IV or frequent subcutaneous. If IV it must be carefully monitored. A caveat to insulin is to check potassium prior to administration of insulin. If serum potassium is low, then replacement potassium must be administered. Fluid replacement and improved insulin heps to correct acidosis and move potassium into the cells which is why hypokalemia correction is very important. Recommendation is to check serum glucose and potassium every hour. Selections with bicarb (B and D) are incorrect since bicarb is not a standard of care. Although metabolic acidosis is present, correction with fluids and insulin may help correct the acidosis. Selection A is incorrect since amiodorone is not a standard of treatment since the goal is treating the ketoacidosis and underlying factors related to fluids and insulin.

Learning Outcomes

Test Taking Tip

Video Rationale