Diabetic ketoacidosis Quiz: Ace Your Exams
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A 32-year-old man is admitted to the hospital for management of diabetic ketoacidosis. He is given aggressive IV fluid resuscitation with normal saline, an IV bolus of regular insulin, and placed on a continuous insulin infusion. After initial management, his disorientation and abdominal discomfort have resolved; however, he continues to have mild nausea. Temperature is 39.2 °C (102.5 °F), blood pressure is 88/62 mmHg, pulse is 130/min, respiratory rate is 24/min, and oxygen saturation is 100% on room air. His fluid was changed to 5% dextrose in half-normal saline 2 hours ago. The most recent laboratory studies are listed below. Which of the following adjustments should be made to the current management?
| Laboratory study | Result | Reference range |
| Sodium | 140 mEq/L | 136-146 mEq/L |
| Potassium | 4.0 mEq/L | 3.5-5 mEq/L |
| Chloride | 105 mEq/L | 95-105 mEq/L |
| Bicarbonate | 10 mEq/L | 22-28 mEq/L |
| Glucose | 188 mg/dL | 70-110 mg/dL |
| Venous pH | 7.28 | 7.35-7.45 |
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