Physiological Adaptation Q 51
Paul is admitted to the hospital due to metabolic acidosis caused by Diabetic ketoacidosis (DKA). The nurse prepares which of the following medications as an initial treatment for this problem?
A. Regular insulin
B. Potassium
C. Sodium bicarbonate
D. Calcium gluconate
Correct Answer: A. Regular insulin
Metabolic acidosis is anaerobic metabolism caused by lack of ability of the body to use circulating glucose. Administration of insulin corrects this problem. The discovery of insulin, along with the antibiotics, has led to a drastic decrease in mortality with DKA, down to 1%. Intravenous insulin by continuous infusion is the standard of care. Previous treatment protocols have recommended the administration of an initial bolus of 0.1 U/kg, followed by the infusion of 0.1 U/kg/h.
Option B: Potassium is an essential mineral constituent of the human body and is the chief cation found within the intracellular fluid of all cells. Multiple salts of potassium exist and can be useful as a medication for a wide range of indications. The chief indication for potassium administration is potassium deficiency or hypokalemia, a condition in which serum potassium level falls below a critical range.
Option C: Sodium bicarbonate is a medication used in the management and treatment of multiple disease pathologies. It is a general chemical compound by classification. Under arrhythmias and cardiovascular instability, sodium bicarbonate can be administered to adults at 4 to 8 hour IV infusions. Each dose should be monitored and planned in a standard protocol to help evaluate the degree of response expected and predicted to understand the necessity to advance further infusions or withhold administration, given its fluid overloading effects.
Option D: Calcium gluconate belongs to a class of drugs called Antidotes; Calcium Salts. It is an over-the-counter and a prescription medicine used to treat symptoms of hypocalcemia and as a calcium supplement. Calcium gluconate is used to treat conditions arising from calcium deficiencies such as hypocalcemic tetany, hypocalcemia related to hyperparathyroidism, and hypocalcemia due to rapid growth or pregnancy.