A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

Choice A reason: Glucocorticoid medications are not indicated in DKA. They can actually worsen hyperglycemia by increasing gluconeogenesis and insulin resistance. Therefore, they are inappropriate in this scenario. Choice B reason: Oral hypoglycemic medications are not effective in treating DKA. DKA requires immediate correction with IV fluids, IV insulin, and electrolyte replacement. Oral agents act too slowly and are not suitable for acute management. Choice C reason: Administration of 0.9% sodium chloride IV bolus is the correct initial treatment. Clients with DKA are severely dehydrated due to osmotic diuresis from hyperglycemia. Rapid fluid replacement with isotonic saline restores intravascular volume, improves perfusion, and helps lower blood glucose levels before insulin therapy is initiated. This is the correct answer. Choice D reason: Dextrose 5% in 0.45% sodium chloride is used later in DKA management, once blood glucose levels fall to around 250 mg/dL. At that point, dextrose prevents hypoglycemia while continuing insulin therapy. It is not appropriate as the initial intervention when glucose is critically high at 925 mg/dL.