A patient admitted with diabetic ketoacidosis has an initial serum potassium level of 3.1 mEq/L. What is the essential immediate action prior to starting intravenous regular insulin infusion?

Answer and explanation

Correct answer: C. Administer intravenous potassium chloride until levels exceed 3.3 mEq/L

Answer: Administer intravenous potassium chloride until levels exceed 3.3 mEq/L.
Why not the others: Starting insulin while potassium is below 3.3 mEq/L shifts potassium into cells and precipitates fatal cardiac dysrhythmias or arrest; Sodium bicarbonate is not indicated for moderate acidosis and causes paradoxical central nervous system acidosis; Polystyrene sulfonate lowers potassium further, worsening dangerous hypokalemia.

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