Fluid & Electrolyte Q 72

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Jon has a potassium level of 6.5 mEq/L, which medication would nurse Wilma anticipate?

  

    A. Potassium supplements

    B. Kayexalate

    C. Calcium gluconate

    D. Sodium tablets

    

    

Correct Answer: B. Kayexalate

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The client’s potassium level is elevated; therefore, Kayexalate would be ordered to help reduce the potassium level. Kayexalate is a cation-exchange resin, which can be given orally, by nasogastric tube, or by retention enema. Potassium is drawn from the bowel and excreted through the feces.

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Option A: Because the client’s potassium level is already elevated, potassium supplements would not be given. Patients with neuromuscular weakness, paralysis, or ECG changes and elevated potassium of more than 5.5 mEq/L in patients at risk for ongoing hyperkalemia, or confirmed hyperkalemia of 6.5 mEq/L should have aggressive treatment. Exogenous sources of potassium should be immediately discontinued.

Option C: Neither calcium gluconate nor sodium tablets would address the client’s elevated potassium level. Calcium therapy will stabilize the cardiac response to hyperkalemia and should be initiated first in the setting of cardiac toxicity. Calcium does not alter the serum concentration of potassium but is a first-line therapy in hyperkalemia-related arrhythmias and ECG changes.

Option D: Sodium bicarbonate infusion may be helpful in patients with metabolic acidosis. Bolus dosing of sodium bicarbonate is less effective. Loop or thiazide diuretics may be helpful in enhancing potassium excretion. They may be used in non-oliguric, volume overloaded patients but should not be used as monotherapy in symptomatic patients.

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