INTRODUCTION Type 1 diabetes mellitus (T1DM) is an autoimmune disorder leading to the destruction of insulin producing pancreatic beta cells, resulting in elevated blood sugar levels 1. Polyuria, polydipsia and weight loss are the key presenting symptoms 2. A systematic review and meta-analysis reported the global T1DM prevalence of 9.5%, with an incidence of 15 per 100,000 people3. Diabetic ketoacidosis (DKA) is a grievous complication of diabetes mellitus caused by insufficient insulin, resulting in elevated blood glucose, ketonemia and acidosis. The overall DKA prevalence across 13 countries over 13 years was 29.9%, with a 3.5% prevalence in Nepal. 4,5.The most common risk factors leading to DKA include missed insulin doses and infections, while other factors like stress-inducing events or the initial onset of diabetes can also trigger DKA. The clinical manifestations of DKA encompass a range of symptoms, including nausea, severe vomiting, dehydration, polyuria, polydipsia, abdominal pain or discomfort, presence of acetone breath odor, Kussmaul breathing, overall profound fatigue with altered consciousness, disorientation, confusion or occasionally coma when the condition is severe 6. Typical diagnosing criteria for DKA include blood glucose greater than 250 mg/dl, arterial pH less than 7.3, serum bicarbonate less than 15 mEq/l, and the presence of ketonemia or ketonuria 7.Immediate intervention is crucial that includes restoring the circulatory volume, correcting electrolyte abnormalities, insulin therapy and addressing the underlying cause 8. Failure to promptly treat DKA can result in the breakdown of compensatory mechanisms and cause electrolyte abnormalities like hyponatremia, hyperkalemia and ultimately lead to life threatening complications including cerebral edema, acute respiratory distress syndrome, and sepsis.  Nursing management for a patient with Diabetic Ketoacidosis (DKA) involves a comprehensive approach that involves monitoring vital signs, blood sugar levels, and electrolytes, administering fluids, assessing renal function and mental status, monitoring intake output, checking for signs of infection, assessing lung sound; educating the patient on insulin injection techniques, medication compliance, promoting lifestyle changes like smoking cessation and diabetic diet9.In DKA, dilutional hyponatremia is common due to rising glucose level that creates osmolar gradient causing water to shift from cells into the intravascular space. However, on rare occasion, hypernatremia is found that happens when there’s a deficit of water intake and excessive loss of free water, which outweighs electrolyte loss through various factors10. This report emphasizes the significance of a fluid management strategy for DKA patients, even when encountering the unusual occurrence of hypernatremia.