The nurse is caring for a patient with an acute kidney injury (AKI). While analyzing the labs, the nurse observes that the patient's potassium is 6.2 mEq/L (reference range 3.5-5.0 mEq/L). Which medications does the nurse anticipate the provider to order to lower the patient's potassium level?

A. Lactated Ringer solution 1-liter infusion over 1 hour: Lactated Ringer contains potassium (about 4 mEq/L), so administering it to a patient with hyperkalemia could worsen potassium levels rather than lower them. While fluid resuscitation may be needed for AKI, it is not an effective or safe intervention for acute hyperkalemia. B. Spironolactone 12.5 mg IV push, followed by hydrochlorothiazide 25 mg IV push: Spironolactone is a potassium-sparing diuretic and would exacerbate hyperkalemia. Hydrochlorothiazide promotes potassium excretion but is not used intravenously, and combining it with spironolactone would counteract potassium-lowering effects. C. Eplerenone 25 mg IV infusion over 1 hour: Eplerenone is also a potassium-sparing diuretic, which would increase serum potassium levels. Administering it to a patient with a potassium of 6.2 mEq/L is contraindicated, as it can precipitate cardiac arrhythmias or worsen hyperkalemia. D. Dextrose 25 GM IV push, followed by regular insulin 10 units IV push: This combination is a rapid-acting, medically appropriate intervention for acute hyperkalemia. Insulin drives potassium into cells, lowering serum levels, and dextrose prevents hypoglycemia. This therapy temporarily stabilizes potassium levels while definitive treatment (e.g., dialysis or potassium excretion) is arranged.