Endocrinology · case mode

Ketones 5.8, potassium 3.1

A 19-year-old with type 1 diabetes has vomited all day after running out of insulin. Glucose 32 mmol/L, capillary ketones 5.8 mmol/L, venous pH 7.05, bicarbonate 6 mmol/L, potassium 3.1 mmol/L, pulse 122/min, blood pressure 96/58 mmHg. He weighs 60 kg and has had 1 L of 0.9% sodium chloride.

hard4 decisionsdiabetic ketoacidosis

1
Potassium is 3.1 mmol/L. What happens next?
2
He weighs 60 kg. What is the fixed-rate insulin infusion rate?
Answer the previous step to continue.
3
Four hours later glucose is 12.5 mmol/L and ketones are 3.4 mmol/L. What do you change?
Answer the previous step to continue.
4
Ketones are 0.4 mmol/L, pH 7.34, bicarbonate 19 mmol/L and he is eating. How do you convert?
Answer the previous step to continue.

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Potassium is 3.1 mmol/L. What happens next?

He weighs 60 kg. What is the fixed-rate insulin infusion rate?

Four hours later glucose is 12.5 mmol/L and ketones are 3.4 mmol/L. What do you change?

Ketones are 0.4 mmol/L, pH 7.34, bicarbonate 19 mmol/L and he is eating. How do you convert?