A 68 year old African American male patient on chronic dialysis comes into the hospital with nausea and vomiting that began 6 hours previously. The patient has mild abdominal bloating and some mild tenderness in the epigastrium and peri-umbilical area, but there is no guarding or rebound. No bowel sounds are heard. The patient has labs drawn and the serum potassium is 7.2 mEq/L. His electrocardiogram is shown below. All of the following would be reasonable next steps, except:
A.) Treatment with Kayexalate 30 grams with 30 cc's of sorbitol
B.) 10 mEq of calcium gluconate immediately
C.) Calcium gluconate and 10 units of soluble insulin and 50 grams of dextrose IV
D.) Medical treatment with calcium gluconate IV and immediate hemodialysis
A.) Treatment with Kayexalate 30 grams with 30 cc's of sorbitol
B.) 10 mEq of calcium gluconate immediately
C.) Calcium gluconate and 10 units of soluble insulin and 50 grams of dextrose IV
D.) Medical treatment with calcium gluconate IV and immediate hemodialysis
