You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 45 year old male known case of diabetes presents with nausea , multiple episodes of vomiting and abdominal pain.He is stuporous , having blood glucoselevel of 402 mg% and on urine examination Ketone bodies are detected.He is having tachycardina along with ohostatic hypotension. On lab investigation,his potassium levels are 3 meq/L.The next best step in the management will be: and explain in detail?
This is a case of diabetic ketoacidosis (DKA)- Patient's serum K+ level is< 3.3 meq/L,In such cases K+ Level need to be corrected first, even before administering insulin. So next best steps in the management of this patient include: Correct hypokalemia-Repeat K+levels in serum-Give IV regular insulin after K+ level is> 3.3 meq/L Even during the treatment with insulin and fluids, Hypokalemia worsens because of: Insulin mediated potassium entry into cells Settlement of acidosis K+ loss in urine Therefore if we won't correct hypokalemia (<3.3 meq/L) in case of DKA, it will aggravate with the insulin and fluids if given initially. Note-Nausea and severe vomiting are due to the ketonemia which trigger vomiting center- CTZ