Free BCEN Certified Emergency Nurse (CEN) Practice Question

In patients with hyperkalemia, the priority is to stabilize cardiac membranes to prevent arrhythmias, particularly when the patient exhibits ECG changes or is symptomatic, as in the provided case. While insulin and dextrose, as well as nebulized albuterol, would also help to temporarily shift potassium into cells, the stabilization of cardiac cells with calcium is the most immediate need. Kayexalate is used to remove potassium from the body but acts more slowly and would not address the immediate risk of cardiac arrhythmias.