DRUG STUDY

Brand Name: Kalexate, Kayexalate, Kionex Generic Name: _Sodium Polystyrene Sulfonate___ Drug Classification: Cation
exchange resin. CLINICAL: Antihyperkalemic.

Dosage, Route & Frequency Drug-Drug & Side Effects Adverse Reactions
Drug Action Drug-Food Indications Contraindications
Recommended Prescribed (By System) (By System)
Interactions

PO 30 g PO x Releases DRUG: Treatment of Contraindications: Frequent: High Potassium

2 doses, 6 sodium ions Cation- hyperkalemia Hypokalemia, neonates dosage: Anorexia, deficiency may
•  Shake hours in exchange donating . with reduced GI nausea, vomiting, occur. Early signs
suspension well apart. primarily antacids, motility, intestinal constipation. High of hypokalemia
prior to for laxatives obstruction/perforation, dosage in elderly: include confusion,
administration. potassium (e.g., any postoperative pt Fecal impaction delayed thought
  ions. magnesium until normal bowel (severe stomach processes,
Therapeutic hydroxide) function resumes. pain with extreme
•  Do not mix
Effect: may Cautions: Severe HF, nausea/vomiting). weakness,
with orange
Moves decrease hypertension, edema. Occasional: irritability, EKG
juice. 
potassium effect; may Diarrhea, sodium changes (often
•  Chilling from blood cause retention associated with
suspension will into systemic (decreased prolonged QT
increase intestine to alkalosis in urination, interval; widening,
palatability. be expelled pts with peripheral flattening, or
from the renal edema, increased inversion of T
body. impairment. weight). wave; prominent
HERBAL: U waves).
Hyperkalemia None Hypocalcemia,
significant. manifested by
FOOD: None abdominal/muscle
PO: ADULTS, known. cramps, occurs
ELDERLY: 60 ml LAB VALUES: occasionally.
May Arrhythmias,
(15 g) 1–4 decrease severe muscle
times daily. serum weakness may be
calcium, noted.
magnesium,
potassium.
May
increase
serum
sodium

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)

Assessment Implementation
● Monitor response of symptoms of hyperkalemia (fatigue,  Consult health care professional regarding discontinuation of medications that
muscle weakness, paresthesia, confusion, dyspnea, peaked may increase serum potassium (angiotensin-converting enzyme inhibitors,
T waves, depressed ST segments, prolonged potassium-sparing diuretics, potassium supplements, salt substitutes).

QT segments, widened QRS complexes, loss of P waves, ● An osmotic laxative (sorbitol) is usually administered concurrently to prevent
and cardiac arrhythmias). constipation.

Assess for development of hypokalemia (weakness,
fatigue, arrhythmias, flat or inverted T waves, prominent U
waves).
● Monitor intake and output ratios and daily weight.
Assess for symptoms of fluid overload (dyspnea,
rales/crackles, jugular venous distention, peripheral
edema). Concurrent low-sodium diet may be ordered for
patients with HF.
● In patients receiving concurrent digoxin, assess for
symptoms of digoxin toxicity (anorexia, nausea, vomiting,
visual disturbances, arrhythmias).
● PO: For oral administration, shake commercially-available suspension well before
use. When using powder, add prescribed amount to 3– 4 mL water/g of powder.
Shake well. Syrup may be ordered to improve palatability. Resin cookie or candy
recipes are available; discuss with pharmacist or dietitian.
● Retention Enema: Precede retention enema with cleansing enema. Administer
solution via rectal tube or 28-French Foley catheter with 30-mL balloon. Insert tube
at least 20 cm and tape in place.
● For retention enema, add powder to 100 mL of prescribed solution (usually
sorbitol or 20% dextrose in water). Shake well to dissolve powder thoroughly;
should be of liquid consistency. Position patient on left side and elevate hips on
pillow if solution begins to leak. Follow administration of medication with
● Assess abdomen and note character and frequency of
stools. Discontinue sodium polystyrene sulfonate if patient
becomes constipated. Concurrent sorbitol or laxatives may
be ordered to prevent constipation or impaction. Some
products contain sorbitol to prevent constipation. Patient
should ideally have 1– 2 watery stools each day during
therapy. Monitor for intestinal necrosis if sorbitol is added.
additional 50– 100 mL of diluent to ensure administration of complete dose.
Encourage patient to retain enema as long as possible, at least 30– 60 min.
● After retention period, irrigate colon with 1– 2 L of non– sodium-containing
solution. Y-connector with tubing may be attached to Foley or rectal tube;
cleansing solution is administered through one port of the Y and allowed to drain
by gravity through the other port.

● Lab Test Considerations: Monitor serum potassium daily

during therapy. Notify health care professional when Evaluation
potassium to 4– 5 mEq/L.
 Normalization of serum potassium levels.
● Monitor renal function and electrolytes (especially
sodium, calcium, bicarbonate, and magnesium) prior to
and periodically throughout therapy.
Patient Teaching

● Explain purpose and method of administration of medication to patient.

Diagnoses
● Advise patient to avoid taking antacids or laxatives during therapy, unless
approved by health care professional; may cause systemic alkalosis.

 Constipation (Side Effects) ● Inform patient of need for frequent lab tests to monitor effectiveness.