Sodium polystyrene sulfonate (Kayexalate) is ordered for a ...

[BRWH]

Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before administering the medication, the nurse should assess the
 
  a. bowel sounds.
  b. blood glucose.
  c. blood urea nitrogen (BUN).
  d. level of consciousness (LOC).

Question 2

Which statement by a 62-year-old patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective?
 
  a. I need to get most of my protein from low-fat dairy products.
  b. I will increase my intake of fruits and vegetables to 5 per day.
  c. I will measure my urinary output each day to help calculate the amount I can drink.
  d. I need to take erythropoietin to boost my immune system and help prevent infection.

[shaikhs]

Answer to Question 1

ANS: A
Sodium polystyrene sulfonate (Kayexalate) should not be given to a patient with a paralytic ileus (as indicated by absent bowel sounds) because bowel necrosis can occur. The BUN and creatinine, blood glucose, and LOC would not affect the nurse's decision to give the medication.

Answer to Question 2

ANS: C
The patient with end-stage kidney disease is taught to measure urine output as a means of determining an appropriate oral fluid intake. Erythropoietin is given to increase the red blood cell count and will not offer any benefit for immune function. Dairy products are restricted because of the high phosphate level. Many fruits and vegetables are high in potassium and should be restricted in the patient with CKD.