A 72-year-old female presents with severe generalized weakness. ECG reveals tall, peaked T waves, prolonged PR interval, and loss of P waves. Serum potassium is 7.2 mEq/L. What is the immediate first-line medication?
Answer and explanation
Correct answer: C. Intravenous calcium gluconate to stabilize cardiac membranes
- Step 1: The patient has severe hyperkalemia with life-threatening ECG changes indicating imminent ventricular fibrillation or asystole.
- Step 2: Intravenous calcium gluconate directly antagonizes potassium-induced membrane depolarization and stabilizes myocyte membranes within minutes.
- Step 3: Calcium does not lower potassium levels; insulin, albuterol, and resins are given subsequently to shift and remove potassium.
Answer
Intravenous calcium gluconate to stabilize cardiac membranes.
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