Question

A patient with hyperkalemia and elevated urea levels underwent dialysis. Towards the end of the session, she became drowsy and had a sudden seizure episode. On examination, thepatient was hypotensive. What is the treatment for this condition?

• A. Bumetanide
• B. Ethacrynic acid
• C. Nesiritide
• D. Mannitol

Answer 1

The Correct Option is D

A patient undergoing dialysis for hyperkalemia and elevated urea levels experiences drowsiness, seizures, and hypotension towards the end of the session. The change in the patient's condition is likely due to dialysis-related cerebral edema caused by rapid fluid and electrolyte shifts. This situation necessitates prompt treatment to reduce intracranial pressure and relieve cerebral edema.

Correct treatment: Mannitol

Mannitol is an osmotic diuretic used to decrease intracranial pressure by drawing fluid out of brain tissues, thus alleviating cerebral edema. Administering mannitol effectively manages the sudden neurological symptoms in this context.

Explanation of incorrect options:

• Bumetanide: A loop diuretic used mainly for fluid overload, not specifically effective in treating cerebral edema induced by dialysis.
• Ethacrynic acid: Another loop diuretic with a similar function to Bumetanide, not suitable for relieving cerebral edema.
• Nesiritide: A recombinant form of human B-type natriuretic peptide, used for heart failure, not for managing intracranial pressure.