Which intervention is crucial before administering insulin to a client with DKA?

Before administering insulin to a client with diabetic ketoacidosis (DKA), monitoring serum potassium levels is crucial. In DKA, metabolic acidosis occurs, often leading to potassium shifts within the body. Initially, serum potassium levels may appear elevated due to the hydrogen ions entering cells in exchange for potassium, but as insulin is administered, potassium will shift back into cells, which can cause serum potassium levels to drop precipitously.

This drop in potassium can lead to hypokalemia, which can have significant cardiac risks, including arrhythmias. Therefore, it is essential to check potassium levels prior to starting insulin therapy to manage and prevent severe complications associated with potassium depletion. Based on these considerations, monitoring serum potassium levels not only aids in understanding the client's electrolyte status but also guides appropriate management and replacement therapy as needed during insulin treatment.