Question

Which medication is indicated for the client with hyperkalemia due to chronic glomerulonephritis? A. Kayexalate (sodium polystyrene sulfonate) B. K-Dur (potassium chloride) C. Cephulac (lactulose) D. PhosLo (calcium acetate)

Short answer

Answer: A. Kayexalate (sodium polystyrene sulfonate).

Step-by-step solution

Analyze the medication options

The first step is to analyze each medication option, its primary use, and whether it can be used to treat hyperkalemia. A. Kayexalate (sodium polystyrene sulfonate) - This medication is a type of potassium-binding resin that is used to treat high levels of potassium in the blood. It works by exchanging sodium ions for potassium ions in the intestines, which allows the body to excrete excess potassium. B. K-Dur (potassium chloride) - This medication is a potassium supplement that is used to treat or prevent low levels of potassium in the blood. It should not be used to treat hyperkalemia, as it can cause potassium levels to become even higher. C. Cephulac (lactulose) - This medication is a type of laxative that is primarily used to treat constipation. It can also be used to treat high levels of ammonia in the blood in patients with liver disease. It does not have a direct effect on potassium levels and should not be used to treat hyperkalemia. D. PhosLo (calcium acetate) - This medication is used to treat high levels of phosphate in the blood, which can be caused by kidney disease. It works by binding to phosphate in the intestines and preventing its absorption. It does not have a direct effect on potassium levels and should not be used to treat hyperkalemia.

Select the appropriate medication for the client

Based on our analysis of each medication option, we can determine which medication is appropriate for the client with hyperkalemia due to chronic glomerulonephritis. Kayexalate (sodium polystyrene sulfonate) is the best option for treating hyperkalemia in this case, as it functions as a potassium-binding resin that specifically targets high levels of potassium in the blood. The other medication options either do not have an effect on potassium levels or are designed to treat different conditions. Therefore, the correct answer is: A. Kayexalate (sodium polystyrene sulfonate).

Key concepts

Hyperkalemia Treatment

Hyperkalemia is a medical condition characterized by elevated levels of potassium in the blood. Potassium is important for the normal functioning of nerves and muscles, including the heart. However, too much potassium can be dangerous and lead to severe health issues.

Treatment for hyperkalemia involves several strategies to lower potassium levels safely and effectively:

• Dietary Changes: Reducing the intake of high-potassium foods such as bananas, oranges, potatoes, and spinach can help manage hyperkalemia.
• Medications: Various medications can help lower potassium levels. These include potassium-binding resins and diuretics which increase the excretion of potassium through urine.
• Dialysis: In severe cases, dialysis is necessary to directly remove excess potassium from the blood.

Often, a combination of these approaches is used to effectively manage hyperkalemia, tailored to a person's overall health, the cause of the hyperkalemia, and the urgency of treatment required.

Chronic Glomerulonephritis

Chronic glomerulonephritis is a long-term condition affecting the kidneys' filtration units, called glomeruli. It leads to kidney damage and a gradual decline in kidney function. Over time, it can cause kidney failure if not managed properly.

The causes of chronic glomerulonephritis vary but often include:

• Autoimmune Diseases: Diseases like lupus can mistakenly attack the kidneys.
• Infections: Certain bacterial or viral infections can trigger glomerulonephritis.
• Genetic Factors: Inherited conditions can also lead to this chronic ailment.

Managing chronic glomerulonephritis involves monitoring blood pressure, controlling dietary salt and protein intake, and in some cases, prescribing medications to reduce inflammation and control symptoms.

Kidney function is closely monitored, and the aim is to slow progression and address any complications that arise, including hyperkalemia.

Kayexalate Medication

Kayexalate, also known by its generic name sodium polystyrene sulfonate, is a medication used to treat hyperkalemia. It is specifically helpful in situations where quick management of elevated potassium levels is necessary.

How does Kayexalate work?

• Mechanism of Action: Kayexalate exchanges sodium ions for potassium ions in the intestines. This exchange process facilitates the removal of potassium from the body through feces, thus lowering blood potassium levels.
• Administration: It can be taken orally or as a rectal enema. The method of administration can depend on the patient's condition and preference or medical advice.
• Precautions: It’s important to monitor patients for gastrointestinal issues, electrolyte disturbances, and other potential side effects.

Kayexalate plays a critical role in managing hyperkalemia, especially in chronic conditions like glomerulonephritis, ensuring potassium levels remain in a safe range to prevent complications.

Potassium-binding Resin

Potassium-binding resins, such as Kayexalate, are compounds used to reduce dangerously high potassium levels in the blood. They are especially useful for individuals who are unable to excrete enough potassium through their kidneys due to conditions like chronic glomerulonephritis.

Key Features of Potassium-binding Resins:

• Ion Exchange Process: These resins work by exchanging ions, usually swapping their sodium ions with potassium in the gut. This ion exchange helps reduce potassium levels in the bloodstream.
• Formulation: Available in powder form for suspension, which can be administered orally or rectally depending on clinical needs.
• Effectiveness: Not only do these resins help in managing hyperkalemia, but they also reduce the risk of serious cardiac complications associated with high potassium.

When used correctly, potassium-binding resins are an integral part of treatment protocols for hyperkalemia in patients with compromised kidney function, providing a non-invasive means to reduce potential life-threatening complications.