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Margaret’s heart rate is low and her potassium is high

Merchak Case Challenge # 74 - February 2026 Margaret’s heart rate is low and her potassium is highYou are caring for Margaret. Margret is a 6-day old female, born at 26 weeks GA via vaginal delivery due to preterm labor. Her mother’s serology is negative, and she received one dose of antenatal steroids. Margaret received exogenous surfactant therapy, on conventional ventilation, on trophic feeds of donor breast milk, TPN support via UVC and on Caffeine. Last 36 hours, Margret had increased frequency of desaturations requiring increased vent support, so she was placed on broad spectrum antibiotics. Repeat blood culture is growing Klebsiella Pneumonia. Margaret urine output is diminished and now, she is having frequent events of bradycardia. Her electrolytes are as follow: Na 128 mEq/L, K 7 mEq/L, CL 108 mEq/L, Bicarb 14 mEq/L, Glu 50 mg/dl, BUN 40 mg/dl, Creatinine 2 mg/dl, Ca 7 mg/dl.

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