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Severe hyperkalaemia with ECG changes — RACP Adult Medicine MCQ

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EasyNephrologySevere hyperkalaemia with ECG changesRACP Adult Medicine

A 70-year-old man with CKD presents with weakness. Potassium is 7.1 mmol/L and ECG shows broad QRS complexes with peaked T waves. Blood pressure is 132/78 mmHg. What is the most appropriate management?

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Correct answer: C — Give intravenous calcium gluconate immediately, then shift and remove potassium

ECG changes from severe hyperkalaemia require immediate IV calcium to stabilise the myocardium, followed by insulin-dextrose and potassium removal strategies. Resin, diuretics or diet alone are too slow when conduction is affected. Magnesium is used for torsades, not as first-line hyperkalaemia therapy.

Reference: Therapeutic Guidelines (eTG); AMH