What is a risk of administering dextrose in DKA?

Administering dextrose in the setting of diabetic ketoacidosis (DKA) carries the risk of worsening acidosis. In DKA, the primary issue is that the body is not able to effectively utilize glucose due to a deficiency of insulin, leading to ketone production and resulting in metabolic acidosis. When dextrose is administered without appropriate insulin, it can contribute to elevated blood glucose levels without addressing the underlying insulin deficiency. This situation not only fails to halt the process of ketone body production but can also lead to a further drop in the blood pH, exacerbating the acidosis that characterizes DKA.

In contrast to this correct understanding, the other options do not align with the most significant risks posed by dextrose in DKA. While hyperkalemia, hypoglycemia, and allergic reactions are potential concerns in various clinical scenarios, they are not the primary focus in the context of treating DKA with dextrose specifically. The main risk lies in its potential to worsen the acidotic state when insulin therapy is not concurrently addressing the metabolic derangement.