What is the recommended action if serum potassium levels are normal or low during DKA treatment?

When managing diabetic ketoacidosis (DKA), it is crucial to closely monitor serum potassium levels, as patients often experience fluctuations in potassium due to shifts in acid-base balance and insulin treatment. Even if initial serum potassium levels are normal or low, repletion is important because insulin administration can drive potassium back into the cells, potentially leading to significant hypokalemia.

Adding potassium to fluids is a standard practice when potassium levels are normal or low during DKA treatment. This action helps maintain appropriate serum potassium levels, preventing complications such as cardiac arrhythmias. Continuous monitoring is necessary to assess potassium levels frequently and adjust supplementation accordingly. This proactive approach ensures that potassium levels remain stable throughout the treatment process, as it can mitigate risk and support safer recovery.

In contrast, starting bicarbonate treatment is not recommended for most patients with DKA unless there is severe acidosis (usually a pH below 6.9) due to potential complications. Increasing fluid rate might be part of the overall management of DKA, but it is not specifically indicated based on potassium levels. Discontinuing the insulin infusion would be inappropriate, as insulin is essential for correcting the underlying metabolic derangement in DKA, especially when potassium levels are being monitored and managed appropriately.