A 9 year old girl was admited for dialysis. On laboratory examination her potassium levels were 7.8 mEq/L. Which of the following would quickly lower her increased potassium levels-
Insulin lowers plasma K+ concentration by shifting K+ into cells. The recommended dose is 10 units of intravenous regular insulin followed immediately by 50 mL of 50% dextrose (D50W, 25 g of glucose total); the effect begins in 10-20 min, peaks at 30-60 min, and lasts for 4-6 h. (ref: harrisons. 19E pg 312)
IV calcium gluconate
IV Glucose and insulin
Oral kayexalate in sorbitol
IV NaHCO3
Fluid and electrolytes