<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:You are called to a hemodialysis suite. The patient is a 61-year-old man with a history of hypertension, hypercholesterolemia, and type-2 diabetes mellitus-induced end-stage renal disease who has required hemodialysis for the past year. His current hemodialysis session is nearing the end when the nurse notices that his blood pressure has dropped to 8860 mm Hg from his normal of 14290 mm Hg. The patient denies any shortness of breath or chest pain. He took his daily bisoprolol, metformin, and insulin this morning before coming to the hospital. On examination, the patients blood pressure is 9260 mm Hg, and his heart rate is 119min. Chest auscultation is unremarkable. What is the most appropriate next management step?? A: Stop ultrafiltration and decrease blood flow into the machine, B: Infuse 1 liter of 0.9 saline, C: Administer intravenous calcium gluconate, D: Start the patient on an epinephrine drip, E: Transfuse the patient with 1 unit of packed red blood cells,  <response>: This is a question about managing hypotension during hemodialysis. The key points in the stem are that the patient is on hemodialysis, has developed hypotension, denies shortness of breath or chest pain, and has a fast heart rate. The most likely cause of hypotension in this setting is intravascular volume depletion from ultrafiltration during dialysis. Therefore, the best initial step is to stop ultrafiltration and decrease blood flow into the machine to allow the patient to re-equilibrate. Calcium gluconate, epinephrine, and blood transfusion are not indicated as initial steps. A: Stop ultrafiltration and decrease blood flow into the machine 