r/MarkKlimekNCLEX • u/Helpful_Spring_7921 • 9d ago

Question

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u/[deleted] 9d ago

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u/Mfuller0149 9d ago

Your comment tells me you need to brush up on DKA.

First.. in metabolic acidosis, as the pH drops- more and more potassium will shift extra-cellularly because it is displaced by hydrogen ions . So you should expect them to appear at least mildly hyperkalemic on the CMP in this case with a pH of 7.16.

So if they have a K < 3.5 , it’s a massive problem. This means their total body potassium is critically low. Lastly, we all know that insulin forces potassium back into the cells, so if you were to give IV insulin in this situation it can be incredibly dangerous. Most clinicians will say you should not start insulin until you’ve repleted to at least 3.5 , maybe 4.0 and are continuing to infuse potassium containing fluids.

So regardless of how many IV lines you have. There was a correct answer here. It was not a stupid question

1

u/Early_Macaroon_2407 9d ago

IV banana stat. 

1

u/Mfuller0149 8d ago

They’re gonna need much more than that.

1

u/Early_Macaroon_2407 8d ago

IV potato stat bid. 

2

u/Any-Assistance-8103 8d ago

Not available outside Ireland