Progressive Care Nursing Certification (PCCN) Practice Exam

What electrolyte imbalance is commonly seen in the initial phase of diabetic ketoacidosis (DKA)?

1. Increased potassium and decreased sodium

2. Decreased calcium and elevated glucose

3. Hypophosphatemia and acidosis

4. Increased magnesium and hyperglycemia

The correct answer is: Increased potassium and decreased sodium

In the initial phase of diabetic ketoacidosis (DKA), increased potassium and decreased sodium levels are commonly observed due to several physiological mechanisms. When insulin levels drop significantly, as occurs in DKA, the body cannot effectively transport potassium into the cells, leading to hyperkalemia (elevated potassium levels in the blood). Additionally, the osmotic diuresis caused by hyperglycemia results in the excretion of not only glucose but also sodium, contributing to lower sodium levels in the serum. Furthermore, the acidosis that develops during DKA also influences potassium distribution and metabolism, further complicating electrolyte balance. Thus, the combination of hyperkalemia and hyponatremia is a hallmark of the initial metabolic disturbance seen in this condition. Understanding these changes is crucial for effective management of patients with DKA, as these electrolyte imbalances can have significant implications for cardiac function and overall patient stability.