Approach to hyperkalemia Quiz: Ace Your Exams
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A 56-year-old man with end-stage renal disease presents to the emergency department with progressive swelling, dyspnea, and muscle weakness in both legs. He has also had episodes of palpitations and paresthesias today. He has missed several dialysis appointments this week due to a lack of transportation. Temperature is 37 ℃ (98.6 ℉), heart rate is 80/min, respiratory rate is 16/min, blood pressure 152/92 mmHg, and oxygen saturation is 92% on room air. On examination, rales are heard throughout the bilateral lung fields. 2+ pitting edema is noted in both lower extremities and there is decreased strength in the bilateral lower extremities. Laboratory studies are notable for a creatinine of 13 mg/dL (0.6-1.2 mg/dL) and potassium of 7.5 mEq/L (3.5-5.0 mEq/L). An ECG taken during triage is shown below. Which of the following medications should be immediately administered?

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