A 66-year-old man presents to the emergency department with 2 days of generalized weakness and palpitations after a 3-day gastroenteritis illness with poor oral intake. He has hypertension, type 2 diabetes mellitus, and coronary artery disease with a previous myocardial infarction. His medications are ramipril, spironolactone, furosemide, and empagliflozin, and he has been taking over-the-counter naproxen for knee pain this week. On examination, his mucous membranes are dry and he is orthostatic. Potassium is 7.2 mmol/L (3.5-5.0), creatinine 238 µmol/L (60-110; baseline 105), bicarbonate 22 mmol/L (22-29), and glucose 6.1 mmol/L (3.9-7.8). The ECG shows peaked T waves and a prolonged PR interval.
| Heart rate | 56/min |
| Respiratory rate | 18/min |
| Temperature | 36.8 °C |
| O2 saturation | 97%, room air |
| Blood pressure | 104/62 mm Hg |
Question 1 of 24
Continuous cardiac monitoring is started and IV access is established. Which one of the following is the most appropriate first treatment?
Select 1. (0 / 1 selected)
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