A 25-year-old patient with type 1 diabetes presents to the emergency department with altered mental status, nausea, vomiting, and Kussmaul respirations. Initial labs show blood glucose 650 mg/dL, pH 7.15, bicarbonate 7 mEq/L, and potassium 3.8 mEq/L. After initiating intravenous fluids and insulin, which electrolyte requires the most careful and immediate monitoring and potential repletion?
✓ Correct Answer: Option C
Although initial potassium may be normal or high due to acidosis, insulin therapy drives potassium into cells, causing rapid hypokalemia. Close monitoring and potassium repletion are crucial to prevent life-threatening arrhythmias during DKA treatment.