A 76-year-old woman presents with confusion, nausea, and weakness. She has heart failure and is on an ACE inhibitor and spironolactone. Her serum pota...

Question

A 76-year-old woman presents with confusion, nausea, and weakness. She has heart failure and is on an ACE inhibitor and spironolactone. Her serum potassium is 6.5 mmol/L, creatinine 200 µmol/L, and ECG shows peaked T waves. What is the most appropriate immediate treatment?

Accepted Answer

IV insulin with dextrose and IV calcium gluconate

Answer

Oral sodium polystyrene sulfonate alone

Answer

Increase spironolactone dose and repeat potassium in a week

Answer

IV normal saline only

Answer

Dialysis in 48 hours without acute measures

ca-mccqe1 MCQ (SBA): Hyperkalaemia - emergency management

A 76-year-old woman presents with confusion, nausea, and weakness. She has heart failure and is on an ACE inhibitor and spironolactone. Her serum potassium is 6.5 mmol/L, creatinine 200 µmol/L, and ECG shows peaked T waves. What is the most appropriate immediate treatment?