What is the standard treatment for moderate to severe hyperkalemia?

The standard treatment for moderate to severe hyperkalemia involves a combination of interventions designed to rapidly lower serum potassium levels and protect the heart from the effects of elevated potassium. The correct answer incorporates calcium administration, insulin and glucose, and beta-agonists.

Calcium administration is crucial because it helps to stabilize the cardiac membranes, counteracting the effects of high potassium on cardiac excitability, which reduces the risk of arrhythmias. Insulin, when administered alongside glucose, drives potassium back into the cells, effectively lowering serum potassium levels. The glucose is necessary to prevent hypoglycemia that could result from insulin administration. Beta-agonists, such as albuterol, also promote the intracellular shift of potassium, further decreasing serum potassium levels.

While calcium administration is important, relying on it alone would not be sufficient to treat hyperkalemia, as it does not effectively lower potassium levels in the blood. Other options such as diuretics and fluid restriction may be used in the management of hyperkalemia, but these do not provide immediate correction of dangerously high potassium levels that can cause life-threatening complications. Sodium bicarbonate can be used in certain scenarios, particularly when metabolic acidosis is present, but it is not a standard part of treating hyperkalemia in all