🏥 USMLE Exam Prep

A 60-year-old patient with end-stage renal disease on hemodialysis misses two sessions and presents with weakness and palpitations. ECG shows wide QRS complexes and peaked T waves. Serum potassium is 7.5 mEq/L. What is the immediate first-line intervention to stabilize the cardiac membrane?

A Intravenous calcium gluconate
B Intravenous regular insulin and dextrose
C Nebulized albuterol
D Sodium polystyrene sulfonate (Kayexalate)

✓ Correct Answer: Option A

Intravenous calcium gluconate (or calcium chloride) immediately stabilizes the cardiac membrane by antagonizing the cardiotoxic effects of hyperkalemia. It does not lower serum potassium but protects the heart from arrhythmias.

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