31-A 55-year-old man presents in the Emergency Department with nausea, pallor and lethargy. He has no past medical history of note. On examination, he has normal vital signs and un... 31-A 55-year-old man presents in the Emergency Department with nausea, pallor and lethargy. He has no past medical history of note. On examination, he has normal vital signs and unremarkable systemic examination. Test results indicate sodium 139, potassium 6.9, bicarbonate 14, blood urea nitrogen 14, creatinine 240. ECG showed tall peaked T waves. Which of the following is the most appropriate initial management? A. Haemodialysis B. Nebulised salbutamol C. Insulin dextrose infusion D. Intravenous calcium gluconate.
Understand the Problem
The question pertains to a clinical scenario involving a 55-year-old man with hyperkalemia (elevated potassium levels) and its management. The provided lab results and symptoms suggest an urgent need to address the hyperkalemia and prevent its complications. The question is asking for the best initial treatment among several options.
Answer
Intravenous calcium gluconate
The most appropriate initial management is intravenous calcium gluconate.
Answer for screen readers
The most appropriate initial management is intravenous calcium gluconate.
More Information
In cases of hyperkalemia, where there is evidence of ECG changes like tall peaked T waves, intravenous calcium gluconate is administered as an immediate measure to stabilize the cardiac membrane and protect against dangerous arrhythmias.
Tips
A common mistake is to focus only on reducing potassium levels without first stabilizing the heart, which is crucial to prevent arrhythmias.
AI-generated content may contain errors. Please verify critical information
