A fictional 74-year-old with AKI is oliguric, breathless and has potassium 7.1 mmol/L with ECG changes.
Listen for the assumption.
I will give treatment to shift potassium and recheck tomorrow.
What are the distinct jobs, and what must be monitored after a temporary shift?
Protect the heart when indicated, shift potassium under protocol, arrange removal and repeat ECG, potassium and glucose monitoring while escalating renal support.
Choose an answer below and reveal the reasoning to see consultant feedback at every checkpoint. The full consultant-led synthesis follows after all three decisions.
Go to the first decision ↓The picture develops.
- Potassium 7.1 mmol/L with conduction change
- Oliguria and pulmonary congestion
- AKI with medicines that may raise potassium
Commit before you reveal.
After you select an option, reveal the model reasoning and the consultant’s feedback.
Hear the senior team refine the plan.
The registrar tests the plan, the consultant synthesises the key principle, and the SHO confirms the safer next steps.
Review drugs, volume, obstruction and the cause in parallel—but never before treating the immediate threat.
Use UKKA and local protocols for sequence and monitoring. Do not turn this teaching case into a dosing card.
I will hand over ECG, potassium and glucose trajectories, respiratory status and renal-replacement planning.
What must remain explicit.
- Use local/UKKA hyperkalaemia guidance.
- Monitor ECG, potassium and glucose at protocol intervals.
- Escalate respiratory deterioration or possible renal replacement promptly.
Where reasoning fails.
- Treating the lab number only
- Forgetting rebound after shift
- Delaying renal/critical-care discussion
Hyperkalaemia [trend/ECG], AKI [urine/creatinine], respiratory status [summary], therapy [time/response] and renal plan [named team].
Which part of the plan removes potassium rather than temporarily moving it?