So during UWorld Qs I came across these rationales : To lower K+ potassium levels ---calcium gluconate, then IV reg insulin with dextrose. Another rationale gave answer of Kayexalate (Sodium polystyrene sulfonate) Are all these answers correct ??? In separate circumstances?
Any explanation will be helpful thank you!

K (EXIT) late= Kayexalate so K like potassium exits

Insulin drives potassium and glucose out of the vascular space and into the cell so in your DKA patient you give them insulin which is going to drop their potassium level and glucose so you have to add in the D5W to prevent hypoglycemia

I am not sure about the calcium gluconate.

I am just a student studying for NCLEX as well. I hope this somewhat helps. Good luck to you!

https://emedicine.medscape.com/article/766479-overview

thank you for the explanation!

Calcium gluconate is used for magnesium toxicity and hyper K. you can give it when there's high K bc it helps with the crazy heart arrythmias you can get. (relaxes smooth muscles)

When the K is high you give Kayexalate. This gives you massive diarrhea and you excrete K through the poop. Also, Regular insulin helps take the K out of the blood stream and put it back into the cell. Bicarbonate is also another method. This is like sodium and when you increase the sodium, the K goes down.

Thank you!!

so management of hyperkalemia:
priority tx: calcium gluconate (gives immediate protection to stabilize heart and prevent life-threat dysrrhythmias- ex EKG tall peaked T wave)
after priority tx: IV sodium polystyrene sulfanate, IV regular insulin, IV dextrose/D5W, and hemodialysis
IV sodium polystyrene sultanate (excretes potassium through GI/stools)
IV regular insulin (regular insulin is the only insulin be given IV, and decrease potassium level temporarily by shifting the potassium into cells, which causes a hypoglycemic affect therefore given dextrose)
IV dextrose (to prevent hypoglycemia from IV insulin)
hemodialysis (the most efficient way to decrease potassium levels)

and there are levels to hyperkalemia:
normal 4.5-5
6-7 (tall peaked T wave, prolonged PR intervals)
7-8 (tall peaked T wave, loss of P wave)
>8 (tall peaked T wave, widened QRS)

i learned this info from uworld in one of the rationales, hope it clarified eveything, post more questions, ill try to find them and answer, its helping me study

You will want to watch the wording too. If it was asking how to eliminate K - the only answer is Kayexalate. All the others just move it around.