A patient enters the Emergency Department complaining of nausea and vomiting. The nurse notes a sweet, fruity breath odor, Blood glucose reveals 540 mg/dl. What does the nurse recognize as the priority intervention?

A. Potassium replacement: Potassium replacement is essential in diabetic ketoacidosis (DKA) because insulin therapy drives potassium into cells, potentially causing hypokalemia. However, potassium correction is secondary; if the patient is severely dehydrated or hypotensive, fluid resuscitation takes priority to restore perfusion before potassium administration. B. Dextrose infusion: Dextrose infusion is indicated later in DKA management when blood glucose drops to prevent hypoglycemia during insulin therapy. At a blood glucose of 540 mg/dL, dextrose is not indicated and would worsen hyperglycemia if given initially. C. Fluid resuscitation: The patient presents with hyperglycemia, nausea, vomiting, and fruity breath, consistent with DKA. Hyperglycemia causes osmotic diuresis, leading to severe dehydration and hypovolemia. Restoring intravascular volume with isotonic fluids is the priority intervention to improve perfusion, prevent shock, and facilitate subsequent insulin therapy. D. Insulin SQ: Insulin therapy is critical for correcting hyperglycemia and ketoacidosis. However, administering insulin before correcting volume depletion can worsen hypotension and compromise renal perfusion. Fluid resuscitation must precede insulin in the initial management of DKA.