What is the recommended rate at which IV saline should be administered to a patient with diabetic ketoacidosis during the first hour of treatment?

In the management of diabetic ketoacidosis (DKA), the initial treatment often includes the rapid administration of intravenous (IV) fluids. A bolus infusion of saline is recommended to quickly restore the patient’s hydration status, improve tissue perfusion, and decrease glucose levels. This initial phase is crucial because DKA can lead to severe dehydration and electrolyte imbalances, which need to be corrected as a priority.

Starting a bolus infusion ensures that the necessary fluid volume reaches the circulation quickly, effectively addressing the physiological needs of the patient right at the onset of treatment. It sets a foundation for subsequent management steps, such as insulin therapy and electrolyte replacement, which are critical in stabilizing the patient.

The other options do not reflect the urgency and immediate action required in the first hour of DKA treatment. Continuous drip over several hours would delay the critical initial care. Administering at a slow rate would not sufficiently address the urgent fluid deficit seen in DKA. Waiting until blood sugar levels are stable before administering fluids is not advisable since rehydration needs to occur independently of glucose levels to support effective metabolic correction and patient stabilization.