What is the adult treatment for hyperkalemia presenting with arrhythmias?

The appropriate treatment for hyperkalemia, especially in the presence of arrhythmias, involves stabilizing the cardiac membrane and preventing potentially life-threatening cardiac complications. Administering calcium chloride is a well-established protocol in acute management as it helps to reduce the myocardial excitability associated with high potassium levels. The calcium displaces potassium from cardiac cells, which is crucial because hyperkalemia can lead to serious arrhythmias or even cardiac arrest.

The slow intravenous push of calcium chloride over 2 minutes allows for safer administration while monitoring for any immediate reactions and preventing a rapid increase in calcium levels that could lead to complications. It's important to note that the typical dose for an adult is indeed 1 gram, aligning with standard protocols for managing acute hyperkalemia.

Other treatment modalities exist; however, they serve different purposes. For instance, nebulized albuterol may help temporarily shift potassium into cells, but it is not the primary treatment during an arrhythmic emergency. Hydration with normal saline might be utilized for volume resuscitation and improving renal excretion of potassium but is not immediately effective in stabilizing the myocardium. Similarly, while calcium chloride can be administered more quickly, safety is a priority, especially in a compromised cardiac situation.

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