A 68-year-old patient with a history of heart failure develops acute kidney injury. Laboratory results show a serum creatinine of 3.2 mg/dL (baseline 1.1 mg/dL) and a potassium level of 6.5 mEq/L with peaked T-waves on ECG. Which of the following is the most appropriate initial management step for the hyperkalemia?

The correct answer to the question "A 68-year-old patient with a history of heart failure develops acute kidney injury. Laboratory results show a serum creatinine of 3.2 mg/dL (baseline 1.1 mg/dL) and a potassium level of 6.5 mEq/L with peaked T-waves on ECG. Which of the following is the most appropriate initial management step for the hyperkalemia?" is Option D: Administer IV calcium gluconate..

The other options — A) Administer IV insulin and dextrose., B) Administer oral sodium polystyrene sulfonate., C) Initiate continuous renal replacement therapy. — are incorrect for this USMLE Exam Prep question. As explained above: Given the ECG changes (peaked T-waves), the hyperkalemia is considered severe and immediately life-threatening. IV calcium gluconate is the fastest way to stabilize the cardiac membrane and prevent a…