Paramedic National Registry Practice

What is commonly the first step in managing a patient with signs of hyperkalemia?

1. Administer calcium gluconate

2. Administer furosemide

3. Initiate CPR

4. Monitor blood pressure closely

The correct answer is: Administer calcium gluconate

The first step in managing a patient with signs of hyperkalemia is to administer calcium gluconate. This intervention is crucial because hyperkalemia can cause dangerous cardiac effects, particularly arrhythmias. Calcium gluconate helps to stabilize the cardiac membrane and counteract the effects of elevated potassium levels on the heart. This is critical in preventing life-threatening complications while other treatments to reduce potassium levels, such as diuretics or dialysis, can be initiated. In situations of hyperkalemia, it's paramount to address the immediate risk of cardiac arrest. Monitoring blood pressure and other supportive measures may follow, but the priority is to protect the heart muscle from the adverse effects of high potassium. In cases where medications like furosemide are considered, they would typically be administered after the initial stabilization with calcium gluconate. CPR is only necessary if the patient is unresponsive or not breathing, and while monitoring vital signs is important, it does not take precedence over stabilizing cardiac function.