A 19-year-old man with type 1 diabetes mellitus presents to the emergency department with abdominal pain, vomiting, and confusion. He has not taken insulin in 48 hours. Vital signs show BP 102/58 mmHg, HR 118/min, RR 28/min, temperature 37.2°C. Laboratory studies reveal glucose 620 mg/dL, arterial pH 7.18, bicarbonate 10 mEq/L, anion gap 16 mEq/L, potassium 5.9 mEq/L, and positive serum ketones. Mucous membranes are dry and Kussmaul respirations are noted on examination. Which insulin preparation is most appropriate to initiate intravenously at this time?
- A)Regular insulinGABARITO
- B)Insulin lispro
- C)Insulin glargine
- D)NPH insulin
- E)Insulin degludec
Explicação
Regular insulin is the insulin preparation routinely given intravenously in diabetic ketoacidosis. It lowers serum glucose and also shifts potassium intracellularly, which is especially relevant in this patient with apparent hyperkalemia. Ver explicação completa e trilha adaptativa →