<prompt> A 9 year old girl was admited for dialysis. On laboratory examination her potassium levels were 7.8 mEqL. Which of the following would quickly lower her increased potassium levels-IV calcium gluconateIV Glucose and insulinOral kayexalate in sorbitolIV NaHCO3  <response>: Insulin lowers plasma K concentration by shifting K into cells. The recommended dose is 10 units of intravenous regular insulin followed immediately by 50 mL of 50 dextrose D50W, 25 g of glucose total; the effect begins in 10-20 min, peaks at 30-60 min, and lasts for 4-6 h. ref: harrisons. 19E pg 312 