Registered Nurse (RN) Endocrine Licensure Exam

Which electrolyte imbalance is commonly associated with DKA?

1. A. Hyperkalemia

2. B. Hypokalemia

3. C. Hypernatremia

4. D. Hyponatremia

The correct answer is: A. Hyperkalemia

Hyperkalemia is a common electrolyte imbalance associated with diabetic ketoacidosis (DKA). In DKA, the body experiences a severe insulin deficiency, which leads to increased levels of glucose in the blood. The lack of insulin prevents glucose from entering cells, causing the body to break down fat for energy. This process generates ketones and results in metabolic acidosis. As acidosis develops, potassium shifts from the intracellular space into the bloodstream, causing a rise in serum potassium levels. Although there may be a total body deficit of potassium due to urinary losses, the immediate hyperkalemia can be misleading as it reflects the redistribution of potassium and not an actual increase in the body's potassium stores. Monitoring potassium levels is crucial in DKA management, as the administration of insulin and correction of acidosis can lead to a rapid decline in serum potassium levels, potentially resulting in hypokalemia if not managed appropriately.