A 24-year-old man with type 1 diabetes presents to the emergency department with 2 days of polydipsia, polyuria, nausea, vomiting, and abdominal pain. On examination, he is lethargic, has Kussmaul respirations, and a fruity odor on his breath. His glucose is 650 mg/dL, pH 7.18, bicarbonate 10 mEq/L, and moderate ketones in his urine. Which of the following is the most appropriate initial fluid management strategy?
✓ Correct Answer: Option B
In diabetic ketoacidosis (DKA), significant volume depletion is present. The initial fluid management involves aggressive rehydration with 0.9% normal saline to restore circulating volume and tissue perfusion. Dextrose-containing fluids are used later once glucose levels drop.