QuestionSBA
QuestionChoice
This is incorrect as it is the mechanism of bicarbonate, which does also have a role in the treatment of hyperkalaemia.
10006987
b
Shift of potassium intracellularly by raising pH
QuestionChoice
This is incorrect as it is the mechanism of insulin when given to patients with hyperkalaemia. This also forms a vital part of the initial management for this patient, but calcium gluconate is typically given first as it is cardioprotective, and arrhythmias are the primary cause of mortality. Dextrose is usually given with insulin in these patients to minimise the risk of hypoglycaemia. This is a similar mechanism to salbutamol, which may also be used in hyperkalaemia.
10006988
c
Shift of potassium ions into cells via activation of Na/K ATPase
QuestionChoice
This is the mechanism of calcium resonium. This prevents the body from absorbing excess potassium in the GI tract. It may be given PR or orally, and may be given alongside other treatments.
10006989
d
Prevention of potassium absorption in the GI tract
QuestionChoice
This is correct. Calcium gluconate is administered as a first-line agent in patients with severe hyperkalaemia to protect cardiomyocytes and prevent life-threatening arrhythmias. Calcium increases the threshold potential, restoring the normal gradient between threshold potential and resting membrane potential, which is typically elevated in hyperkalaemia.
10006986
a
Stabilisation of cardiomyocyte membrane potentials
QuestionChoice
This is incorrect. This is the mechanism of diuretics such as loop diuretics. Although this may result in a fall in potassium over time, it would not provide a reduction fast enough to be used in the immediate management of this patient.
10006990
e
Decreased renal potassium reabsorption
Concept
Chapter
2693
3934
hyperkalaemia
Topic
170
Clinical Chemistry
13944
A 48-year-old woman presents to A&E with palpitations, weakness, and shortness of breath. An arterial blood gas is performed which demonstrates a potassium level of 7.0. As part of the initial management, she is given IV calcium gluconate.

What is the role of calcium gluconate in the management of this patient's hyperkalaemia?
a