Pediatric Fluid and Electrolyte Imbalances · NCLEX Exam

Why is potassium replacement critical even before insulin therapy in a child with diabetic ketoacidosis (DKA)?

  1. Insulin shifts potassium into cells, lowering serum K+ further
  2. Insulin reliably raises the potassium level in the blood
  3. Potassium replacement is essentially never indicated in DKA
  4. Close monitoring of the child is not necessary during treatment
Show answer and explanation

Correct answer: Insulin shifts potassium into cells, lowering serum K+ further

In DKA, even if serum K+ appears low, insulin therapy will drive potassium into cells, worsening hypokalemia unless replaced appropriately.

Difficulty: Medium Question 11 of 23

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