Pediatric Fluid and Electrolyte Imbalances · NCLEX Exam

Why is potassium replacement still likely needed even if a child with DKA has an initial potassium level of 5.8 mEq/L?

  1. Because serum potassium stays high throughout treatment
  2. Because insulin and fluids drive K+ into cells while urinary losses continue
  3. Because only the sodium level is clinically relevant here
  4. Because children are unable to excrete potassium effectively
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Correct answer: Because insulin and fluids drive K+ into cells while urinary losses continue

Even if initial serum potassium is elevated in DKA, total body potassium is depleted and once insulin and fluid therapy start, potassium shifts intracellularly and urinary losses continue—requiring replacement.

Difficulty: Medium Question 20 of 23

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