The nurse instructs a patient with acute kidney injury that the ...

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The nurse instructs a patient with acute kidney injury that the expected result of taking sodium polystyrene sulfonate (Kayexalate) is to do what?
 
  1. remove potassium
  2. replace sodium
  3. replace magnesium
  4. exchange calcium for sodium

Question 2

The nurse is preparing to administer an osmotic diuretic to a patient. What should the nurse do when providing this medication?
 
  Select all that apply.
  1. Check solution for crystallization prior to IV administration.
  2. Evaluate urine output after test dose is given.
  3. Assess for signs of worsening heart failure.
  4. Assess for orthostatic hypotension.
  5. Monitor patient for signs of ototoxicity.

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Answer to Question 1

Correct Answer: 1
Sodium polystyrene sulfonate (Kayexalate) is given to remove potassium in the patient with acute kidney injury by exchanging sodium for potassium, primarily in the large intestine. It is not used to replace sodium or magnesium, or to exchange calcium for sodium.

Answer to Question 2

Correct Answer: 2, 3
Osmotic diuretics pull extracellular water into the vascular system and increase the glomerular filtration rate (GFR). A test dose may be given and urine output is evaluated for an adequate response. The patient should be assessed for signs of worsening heart failure because of the increased vascular volume that occurs with these medications. Orthostatic hypotension is not an issue due to the increase in intravascular volume but should be assessed when giving loop diuretics. Ototoxicity is a concern with high doses of loop diuretics. There is no documentation that these solutions crystallize.

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Gracias!

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