A 76-year-old man taking ramipril and spironolactone attends with three days of vomiting and increasing lethargy. He is drowsy but rousable. Pulse is 42/min and blood pressure 108/66 mmHg. Serum potassium is 7.4 mmol/L (3.5-5.2) and creatinine 310 micromol/L (60-110). The electrocardiogram shows broad QRS complexes with tall, narrow, peaked T waves and no discernible P waves. Intravenous access is in place and the renal team has been telephoned. Which one of the following should be given first?
Shared by Morniencommon
Filed under internal-medicine › nephrology › fluid-and-electrolyte-imbalances › disorders-of-potassium-balance

Keep going with ten more like this one.

Practise more

More from Acute Care

See all

A 7-year-old boy is ready to leave a Perth emergency department six hours after a moderate asthma flare-up. He has had salbutamol by spacer and a first dose of…

Clinical rotations · middle twist

A 78-year-old woman is being discharged after an admission with melaena. She takes apixaban for atrial fibrillation. Gastroscopy showed a bleeding duodenal ulce…

Clinical rotations · middle twist

You are the intern on a Perth surgical ward. Overnight a 74-year-old woman received ten times the intended dose of insulin because of a prescribing error you ma…

Pre-internship · middle twist

An 81-year-old man had a large left middle cerebral artery infarct ten days ago. He cannot swallow safely and can neither understand nor communicate a decision.…

Pre-internship · middle twist

A 62-year-old Aboriginal woman from a remote Kimberley community is admitted to a Broome hospital with small bowel obstruction and listed for laparotomy on tomo…

Pre-internship · middle twist