🏥 USMLE Exam Prep

A 55-year-old male with a history of hypertension and diabetes is found unresponsive. His blood glucose is 45 mg/dL. After administering intravenous dextrose, he regains consciousness but is confused. His serum potassium is 6.8 mEq/L, and ECG shows peaked T waves. What is the most urgent initial step to stabilize his cardiac membrane?

A Administer intravenous insulin and glucose
B Administer intravenous calcium gluconate
C Administer sodium polystyrene sulfonate
D Administer intravenous sodium bicarbonate

✓ Correct Answer: Option B

The patient has severe hyperkalemia with ECG changes (peaked T waves), indicating cardiac instability. Intravenous calcium gluconate is the most urgent intervention to stabilize the cardiac membrane and prevent life-threatening arrhythmias, acting directly on the myocardial excitability.

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