A 68-year-old man with chronic kidney disease is admitted with pneumonia and has received intravenous fluids, calcium gluconate and insulin with glucose for a serum potassium concentration of 7.1 mmol/L (3.5–5.2). His potassium is now 6.9 mmol/L, the urine output has been 40 mL over the past 6 hours, and the electrocardiogram still shows broad QRS complexes. Which one of the following is the most appropriate next step?
Keep going with ten more like this one.
Practise moreMore from Renal, Urology and Electrolytes
See allA 78-year-old man presents with three days of inability to pass urine and a painful lower abdomen, on a background of months of a poor stream and nocturia. A ur…
Pre-internship · niche
A 63-year-old man who has smoked for 40 years and worked for 20 years in a tyre factory reports that on two occasions in the last month his urine has been brigh…
Clinical rotations · common
A 74-year-old man is on day 2 after an emergency Hartmann procedure for perforated diverticulitis. He takes spironolactone and perindopril for heart failure. He…
Pre-internship · common
A 24-year-old man presents with dark brown urine that began the day after the onset of a sore throat. He recalls two similar episodes in the past two years, eac…
Clinical rotations · middle twist
A 68-year-old woman with recently diagnosed small cell lung cancer is brought in after a generalised tonic-clonic seizure at home. Over three days she has becom…
Pre-internship · middle twist