While caring for a patient with diabetic ketoacidosis (DKA), which of the following lab values would you want to communicate with the HCP before starting an insulin drip?

A. Calcium: 8.5 is incorrect because this value is within the normal reference range (approximately 8.5–10.5 mg/dL). Calcium levels, unless critically abnormal, do not affect the decision to start insulin in DKA. B. Phosphorus: 4.0 is incorrect because this is also within the normal reference range (2.5–4.5 mg/dL). Although phosphorus levels can drop during DKA treatment due to insulin shifting phosphorus into cells, an initial normal phosphorus level does not preclude starting insulin. C. Potassium: 2.8 is correct because hypokalemia is a major safety concern when initiating insulin therapy. Insulin promotes the movement of potassium from the extracellular space into cells, which can further lower already low potassium levels. Severe hypokalemia can lead to life-threatening cardiac arrhythmias, including ventricular tachycardia or fibrillation. For this reason, current guidelines recommend holding insulin until potassium is corrected to ≥3.3 mEq/L and administering potassium replacement as ordered. The nurse must communicate this lab result to the healthcare provider before starting the insulin drip to prevent serious complications. D. Glucose: 275 is incorrect because hyperglycemia is expected in DKA. While high glucose confirms the need for insulin therapy, it is not a contraindication to starting treatment.