The physician has prescribed 30 mEq of potassium gluconate to be given orally once a day in orange juice.

The available concentration of potassium gluconate is 20 mEq per 15 mL.

What is the amount of mL the nurse will administer Instructions: Rounding: For adult clients, the answer should be rounded to the nearest whole number (mg, mcg, and m).

The correct answer is choice A. Daily weight.

According to MDCalc, daily weight is the most accurate indicator of fluid loss or gain in acutely ill patients, as it reflects changes in total body water.

A weight change of 1 kg corresponds to a fluid change of approximately 1 L.

Choice B is wrong because intake and output measurements can be inaccurate or incomplete, and do not account for insensible fluid losses.

Choice C is wrong because serum osmolality reflects the concentration of solutes in the blood, not the volume of fluid.

Choice D is wrong because urine specific gravity reflects the concentration of solutes in the urine, not the volume of fluid.

Choice A reason: This hypotonic saline solution is often used after initial resuscitation, especially when the patient’s serum sodium is normal or elevated. It helps replace intracellular fluid losses and provides ongoing hydration without excessively increasing sodium levels. It is typically administered once the initial intravascular volume is restored with isotonic fluids.

Choice B reason: This isotonic saline solution is the first-line intravenous fluid used in DKA. It helps expand intravascular volume quickly, restore tissue perfusion, and correct hypovolemia caused by osmotic diuresis. It is given initially as a bolus, followed by continuous infusion until the patient is stabilized.

Choice C reason: This dextrose-containing solution is introduced once blood glucose falls to approximately 200–250 mg/dL. At this point, insulin therapy must continue to clear ketones and correct acidosis, but dextrose is added to prevent hypoglycemia. It is usually combined with saline (e.g., D5 0.45% NS) to balance hydration and glucose support.

Choice D reason: This balanced electrolyte solution is not typically the preferred fluid in DKA management because the lactate component may complicate interpretation of acid–base status. Although it can expand volume, it is generally avoided in favor of saline solutions that more directly address dehydration and electrolyte imbalance in DKA.

Choice E reason: This form of insulin is the only type used intravenously in DKA. A continuous infusion of regular insulin is essential to reduce blood glucose, suppress ketone production, and correct metabolic acidosis. It is carefully titrated with close monitoring of electrolytes, especially potassium, since insulin drives potassium into cells and can cause hypokalemia.