A seventy year old man with advanced prostate cancer develops bilateral
ureteral obstruction and acute on chronic renal failure. His potassium
rises to 7.7 with peaked t waves. His medications include digoxin. The most
appropriate, safest initial therapy is
1. Hemodialysis
2. Percutaneous nephrostomy placement
3. Kayexalate
4. Intraveous glucose and regular insulin
5. Intravenous calcium gluconate
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