Question: The Physician Has Given Orders To Administer 0.9% Sodium Chloride IV At 500mL/hour For 1 Hour, Then 200mL/hr For The Next 4 Hours. The Nurse Is To Start A Drip Of Regular Insulin At 0.1mg/kg/hour. The Physician Has Also Added Orders For Laboratory Work, Including A Metabolic Profile And Arterial Blood Gases. The Metabolic Panel Results Are: Na 135 MEq/L, …

The physician has given orders to administer 0.9% Sodium Chloride IV at 500mL/hour for 1 hour, then 200mL/hr for the next 4 hours. The nurse is to start a drip of Regular insulin at 0.1mg/kg/hour. The physician has also added orders for laboratory work, including a metabolic profile and arterial blood gases. The metabolic panel results are: Na 135 mEq/L, K 3,2 mEq/L, C195 mmol/L., Ca 8.5 mg/dL. The arterial blood gas results are as follows: pH 7.31. pCO2 20mmHg, pO2 95mm/Hg, HCO3 12mmol/L. 5. What is the rationale for the IV fluids to be given at this rate? 6. Explain why the patient’s potassium result is at the current level. 7. Based on the metabolic profile results, what is the next step that the nurse would most likely need to perform? 8. Explain why DKA would most likely produce these types of blood gas results.