Which complication is a patient with diabetic ketoacidosis at risk for?

Which complication is a patient with diabetic ketoacidosis at risk for?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypokalemia
• D. Hyperglycemia

Answer: (C)

In diabetic ketoacidosis, potassium balance is tricky because the situation involves both a shift of potassium between compartments and actual losses from the body. Acidosis and insulin deficiency push potassium out of cells, so the lab potassium may be high or normal even though total body potassium is depleted from osmotic diuresis and vomiting. When treatment begins with fluids and insulin, potassium is driven back into cells, and this shift can uncover a true potassium deficit. If potassium falls too low, it can cause dangerous arrhythmias and muscle weakness. That makes hypokalemia the key complication to anticipate during correction. Monitor potassium closely and replace as needed during therapy (holding insulin if potassium is too low and repleting before continuing insulin, then continuing to replete as potassium shifts). Hyperkalemia is more a presenting feature before treatment, and hyponatremia and hyperglycemia are part of the syndrome rather than the therapy-related complication.

In diabetic ketoacidosis, potassium balance is tricky because the situation involves both a shift of potassium between compartments and actual losses from the body. Acidosis and insulin deficiency push potassium out of cells, so the lab potassium may be high or normal even though total body potassium is depleted from osmotic diuresis and vomiting. When treatment begins with fluids and insulin, potassium is driven back into cells, and this shift can uncover a true potassium deficit. If potassium falls too low, it can cause dangerous arrhythmias and muscle weakness. That makes hypokalemia the key complication to anticipate during correction. Monitor potassium closely and replace as needed during therapy (holding insulin if potassium is too low and repleting before continuing insulin, then continuing to replete as potassium shifts). Hyperkalemia is more a presenting feature before treatment, and hyponatremia and hyperglycemia are part of the syndrome rather than the therapy-related complication.