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8th July 2024
You are asked to review a 45-year-old admitted to the acute medical unit last night with nausea
You are asked to review a 45-year-old admitted to the acute medical unit last night with nausea. He denied any past medical history or regular medications. Initial blood results show elevated potassium levels and acute kidney injury. He was treated with multiple rounds of insulin, dextrose and calcium gluconate. His nausea has improved, but he is now complaining of difficulty in breathing.
Observations:
| Blood Pressure | 150/90 mm HG |
| Heart Rate | 112 /min |
| SpO2 | 96% on RA |
| Temperature | 36.8 ⁰C |
Laboratory analysis:
| Haemoglobin | 8.0 g/dl | Sodium | 140 |
| White Blood Corpuscles | 8.0 x 10^6 | Potassium | 7.0 |
| Platelets | 151 x10^6 | Corrected Calcium | 2.12 |
| Creatinine | 960 mmol/dl | Phosphate | 1.54 |
| Urea | 40.4 mmol/dl | Bicarbonate | 18 |
| Albumin | 35 | Glucose | 4 |
What is the next immediate step in the management of this patient?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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