A client with diabetic ketoacidosis (DKA) is receiving an IV infusion of 0.9% sodium chloride and insulin. Two hours later, the client’s serum laboratory results show a decrease in the serum blood glucose from 580 to 430 mg/dL (32.2 to 23.86 mmol/L). What additional laboratory result is most important for the nurse to monitor?

Choice A rationale While monitoring serum sodium levels is important in a client with DKA, it is not the most critical. Hyperglycemia can lead to a state of effective osmotic diuresis, which can cause sodium depletion. Choice B rationale Serum potassium levels are crucial to monitor in a client with DKA3. Despite total body potassium depletion, serum potassium levels may be high or normal upon presentation due to acidosis and insulin deficiency. However, with insulin treatment, potassium will shift back into the cells, potentially leading to life-threatening hypokalemia. Choice C rationale Blood urea nitrogen (BUN) might be elevated due to dehydration, but it is not the most critical lab value to monitor in the management of DKA3. Choice D rationale Urine ketones are not as important to monitor as serum potassium in DKA. The presence of ketones in urine only confirms that the body is breaking down fat, not the severity of DKA3.