A9-year-old girl with type 1 diabetes mellitus is brought to the emergency department because of lethargy, labored breathing, and seven episodes of vomiting over the past 6 hours. her skin is flushed and warm and she appears severely dehydrated. there is a fruity odor to her breath. she is at the 75th percentile for height and 25th percentile for weight. her temperature is 37.2â°c (99â°f), pulse is 110/min, respirations are 24/min, and blood pressure is 100/60 mm hg. capillary refill time is 4 seconds, and capillary blood glucose concentration is greater than 500 mg/dl. which of the following is the most appropriate initial step in management? a)intravenous administration of 20 ml/kg of 5% dextrose in water b) intravenous administration of 20 ml/kg of 0.9% saline c) intravenous administration of 20 ml/kg of lactated ringer solution with 40 meq/l of potassium chloride d) intravenous administration of 0.1 u/h of regular insulin e)continuous intravenous administration of 0.1 u/h of regular insulin