A 32-year-old patient is admitted to the critical care unit with a diagnosis of diabetic ketoacidosis.Following aggressive fluid resuscitation and intravenous (IV)insulin administration,the blood glucose begins to normalize.In addition to glucose monitoring,which of the following electrolytes requires close monitoring?

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Potassium must be closely monitored.In the early stages of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome,the potassium value is often high,but it may lower to critical levels once fluid balance has been restored and glucose has returned to more normal levels.Insulin administration used in the treatment of diabetic ketoacidosis further promotes lowering of potassium as the electrolyte is relocated to the cellular bed.Calcium levels do not drastically change in hyperosmolar states and are not a primary concern unless phosphate replacement is initiated.Chloride levels typically follow sodium levels and normalize with fluid replacement.Sodium levels may initially be elevated as a result of dehydration but will be corrected with fluid replacement.

A 32-Year-Old Patient Is Admitted to the Critical Care Unit