Pharmacology Electrolytes #2

Question

The nurse is caring for a patient receiving sodium polystyrene sulfonate for hyperkalemia. After administration of the medication, what will the nurse monitor to assure the goal of treatment has been met?

Answers

  1. Increased bowel movements
    • Rationale:

      This answer is correct because sodium polystyrene sulfonate is in the class of medications called potassium-removing agents. It removes potassium through increasing motility of the bowel through increased number of bowel movements (diarrhea).

  2. Decreased blood pressure
    • Rationale:

      This answer is not correct because decreased blood pressure is not the goal of treatment for sodium polystyrene sulfonate. Decreased blood pressure indicates an undesired potential side effect of the medication, dehydration. Sodium polystyrene sulfonate removes potassium through increasing motility of the bowel through increased number of bowel movements (diarrhea).

  3. Decreased urine output
    • Rationale:

      This answer is not correct because decreased urinary output is not the goal of treatment for sodium polystyrene sulfonate. Decreased urinary output indicates an undesired potential side effect of the medication, dehydration. Sodium polystyrene sulfonate removes potassium through increasing motility of the bowel through increased number of bowel movements (diarrhea).

  4. Increased PVCs
    • Rationale:

      This answer is not correct because increased premature ventricular contractions (PVCs) occur during hypokalemia, which is not the goal of treatment. Sodium polystyrene sulfonate removes potassium through increasing motility of the bowel through increased number of bowel movements (diarrhea).

Overview

Sodium polystyrene sulfonate is given to patient’s to decrease potassium levels. It removes excess potassium through increased motility of the bowel and increasing the number of bowel movements.

Explanation

The correct answer is A. Polystyrene sulfonate exchanges sodium for potassium in the GI tract. Gastrointestinal disorders like vomiting and constipation may occur. At times diarrhea may occur. Fecal impaction and GI ischemia may occur along with intestinal ulceration or necrosis. Blood pressure and urine output are important; however, since the actions of the medication are targeted for GI, then GI assessments are important. Peaked waves would have already been seen and would not just occur after the administration. Peaked T-waves are indicative of hyperkalemia. Instead, the nurse would monitor for hypokalemia as manifested by u waves or inverted T waves.

Learning Outcomes

Sodium polystyrene sulfonate is in the class of medications called potassium-removing agents. It removes potassium through increasing motility of the bowel through increased number of bowel movements (diarrhea). The patient should be taught that is the purpose of the medication. Depending on the dosage, the medication can take hours to days to work. The normal potassium level is 3.5-5.3 mmol/L. Elevated levels of potassium can cause lethal cardiac arrhythmias and should be reported immediately. Sodium polystyrene sulfonate is prescribed to effectively and quickly decrease potassium levels. The patient’s intake, output, and electrolytes (specifically potassium) should be monitored carefully so dehydration and hypokalemia does not occur.

Test Taking Tip

One of the top lab values a nursing student should know is normal potassium levels. This is because abnormal levels can cause life-threatening cardiac arrhythmias.

Video Rationale