An 82-Year-Old Man Comes to the Emergency Department Because of Sudden

question 15

Multiple Choice

An 82-year-old man comes to the emergency department because of sudden onset back pain.  He denies any lower extremity weakness, bowel or bladder incontinence, muscle cramps, or paresthesias.  He has no fever or chills.  He has a history of chronic lymphocytic leukemia and hyperlipidemia.  He has not received any chemotherapy for his leukemia and lost follow-up with physician appointments.  He does not take any prescription medications.  He denies tobacco, alcohol, or illicit drug use.
His blood pressure is 140/76 mm Hg, pulse is 72/min, and respirations are 14/min.  Examination shows cervical lymphadenopathy and splenomegaly.  He has point tenderness at the L2 level.  The remainder of the examination is within normal limits.
The patient's labs reveal:

An electrocardiogram is normal.  Spinal imaging shows a compression fracture at the level of L2.
Which of the following is the next best step in the management of his hyperkalemia?

• A)Analyze whole blood potassium by using arterial blood draw
• B)Insulin and glucose
• C)Intravenous calcium gluconate
• D)Normal saline at 250 ml/hour to establish high urine flow
• E)Systemic corticosteroids

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Definitions:

Psychoactive Drugs

Substances that, when ingested, alter perception, mood, consciousness, cognition, or behavior by affecting brain function.

Sedatives

A class of drugs that slow down brain activity, used to calm or make someone sleep.

Marijuana Use

The act of consuming marijuana, which can have various effects on cognitive and physical abilities and health.

Empirical Evidence

Information obtained through observation or experimentation that is used as a basis for knowledge or validation of scientific findings.