A 19-year-old man with type 1 diabetes mellitus presents with abdominal pain, vomiting, and altered mental status after missing two days of insulin doses. Vital signs show BP 98/62 mmHg, HR 118 bpm, RR 28 (Kussmaul respirations), temp 37.2°C. Examination reveals dry mucous membranes and decreased skin turgor. Labs reveal glucose 620 mg/dL, pH 7.22 with anion gap 16 mEq/L, potassium 5.9 mEq/L, bicarbonate 10 mEq/L, and negative serum ketones initially. He denies recent cocaine use. Which insulin preparation is most appropriate to initiate intravenously?
- A)Regular insulinGABARITO
- B)Insulin lispro
- C)Insulin degludec
- D)Insulin glargine
- E)NPH insulin
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 →