The nurse assesses the client with an acute kidney injury who has a serum potassium level of 6.8 mEq/L. Which medications should the nurse plan to administer now? Select all that apply.

Rationale: A. Sodium polystyrene sulfonate is indicated for hyperkalemia because it binds potassium in the gastrointestinal tract and promotes its excretion. This medication helps lower serum potassium levels, making it appropriate for a client with a critically elevated potassium level of 6.8 mEq/L. B. A 0.45% saline bolus is not used to treat hyperkalemia. While fluid replacement may be necessary for other causes of acute kidney injury, hypotonic saline does not actively lower potassium and would not address the immediate risk of cardiac complications from hyperkalemia. C. Erythropoietin is used to treat anemia associated with chronic kidney disease, not hyperkalemia. Administering erythropoietin would not affect potassium levels and is not indicated in the acute management of elevated serum potassium. D. Calcium gluconate is used in hyperkalemia to stabilize cardiac membranes. It does not lower potassium levels but reduces the risk of life-threatening cardiac arrhythmias. This makes it a priority intervention in acute management of severe hyperkalemia. E. Regular insulin, given with glucose, helps shift potassium from the bloodstream into cells, lowering serum potassium levels rapidly. This is an essential and immediate treatment for critically high potassium levels, making it appropriate for this client.