In order to lower a high K+ level with Kayexalate, does there need to be a successful bowel movement (i.e. is the K+ excreted with the stool)
The reason I ask is that we have a patient w/K+ 5.4. She is receiving Kayexalate 15gm Q6h. Since she started (2 days ago) she has not had a BM yet (no cramping, Abd SNT, +BSx4). When we notified the MD, he said she did not have to have a BM for the Kayexalate to work on the K+.
The other nurses and I were under the impression that there needed to be a BM in order for the K+ to drop (thinking as in Lactulose + Ammonia).
Could someone clarify this for us?
(Mind you, this is a Geri/Psych unit to we don't see these things on a regular basis)
Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.
Not only has kayexalate never been proven to be the cause of reduced K levels, there has been enough research on the subject for the Cochrane Collaboration (the highest level of EMB available) to declare that kayexalate has no clinically significant effect on reducing K levels, although it has been proven to cause necrosis of the colon (a concerning side effect given your constipated patient. I was surprised when I heard this since it usually appears to work, but in actuality all we are seeing is a naturally mediated reduction of K levels often boosted by induced diarrhea and the loss of electrolytes that goes along with it.
smcabee
15 Posts
I hope now that the K is 3.5 you guys stopped it. Nothing like bottoming (pun intended) :wink2: out that level.