Drug used to treat hyperkalemia is

NHM UP Staff Nurse-2021 Shift-1st

Pharmacology

Easy

Appeared in: NHM UP Staff Nurse-2021 Shift-1st

Explanation

Calcium gluconate is the first-line emergency treatment for severe hyperkalemia, especially when ECG changes are present.
Its primary action is to antagonize the cardiac effects of hyperkalemia by stabilizing the myocardial cell membrane, which reduces cardiac excitability.
This cardioprotective effect raises the action potential threshold, preventing potentially lethal arrhythmias like ventricular fibrillation or asystole.
It is important to note that calcium gluconate does not lower the serum potassium level; it only protects the heart while other therapies are initiated to reduce potassium.

Option A: Atenolol is a beta-adrenergic blocker. Beta-blockers can inhibit the cellular uptake of potassium, leading to an increase in extracellular potassium levels and potentially causing or worsening hyperkalemia.
Option B: Prednisolone is a corticosteroid with anti-inflammatory and immunosuppressive properties. It has no direct role in the acute management of hyperkalemia.
Option C: Nitroglycerine is a vasodilator that works by relaxing smooth muscle and dilating blood vessels. It has no effect on serum potassium levels.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological management of hyperkalemia helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must recognize hyperkalemia as a medical emergency and be prepared to administer IV calcium gluconate promptly under a provider's order, especially if ECG changes are present.
Continuous cardiac monitoring is a critical nursing intervention during the administration of calcium gluconate to assess for therapeutic effects (resolution of ECG changes) and adverse effects (e.g., bradycardia, hypotension).
What if? If the patient is also taking digoxin, IV calcium must be administered with extreme caution (e.g., diluted and infused slowly over 20-30 minutes), as hypercalcemia potentiates the risk of digoxin toxicity.

How to Approach the Question

First, identify the core concept of the question, which is the treatment for 'hyperkalemia' (high serum potassium).
Recall that hyperkalemia is a medical emergency primarily due to its cardiotoxic effects.
The immediate priority in managing severe hyperkalemia is to protect the heart. Think about which drug class serves this specific purpose.
Evaluate the options: Calcium gluconate is the classic agent for stabilizing the cardiac membrane in hyperkalemia.
Eliminate the other options by recalling their primary mechanisms and indications. Atenolol (beta-blocker) can worsen hyperkalemia. Prednisolone (steroid) and Nitroglycerine (vasodilator) are irrelevant to potassium regulation.

Concept Tested & Keywords

QctJ3uq_CLvdZbc3ah3Eol

E6 Medicine Harrison 22e Part 1 p. 402-404

E6 Medicine Davidson Principles Practice 24e p. 383-385

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 152-154