In hyperkalaemia, after IV calcium gluconate stabilises the heart (not offered here), the next urgent step is to shift K⁺ into cells with IV insulin plus glucose/dextrose, which acts quickly.

• Furosemide (B) removes K⁺ only if there is adequate residual renal function, so it is unreliable in CKD.
• Sodium bicarbonate (C) is used only if acidosis is present.