Neonatal Nurse Practitioner Practice Exam

Why is IV 10% calcium gluconate used in managing hyperkalemia in neonates?

1. Facilitates renal excretion of potassium

2. Increases potassium influx into cells

3. Stabilizes the myocardium

4. Reduces blood pressure

The correct answer is: Stabilizes the myocardium

IV 10% calcium gluconate is utilized in managing hyperkalemia in neonates primarily because it stabilizes the myocardium. Hyperkalemia can lead to dangerous cardiac arrhythmias due to elevated potassium levels in the blood, which can affect the function of the heart. Calcium plays a critical role in cardiac muscle contraction and conduction. By administering calcium gluconate, the cardiac membrane potential is stabilized, reducing the risk of arrhythmias and protecting the heart from the toxic effects of high potassium levels. While increasing potassium influx into cells and facilitating renal excretion of potassium are important aspects of hyperkalemia management, those processes are more directly involved with other treatments, such as insulin, glucose, or diuretics, rather than the immediate protective action provided by calcium gluconate. Reducing blood pressure is not a primary concern in treating hyperkalemia, as the primary focus is on cardiac protection and stabilization. Thus, the correct answer highlights the essential role of calcium in cardiac membrane stability in the face of high potassium levels.