Which order regarding enemas should a nurse question?

Which order regarding enemas should a nurse question?

• A. A normal saline enema to be repeated every 4 hours until stool is produced
• B. A hypertonic solution enema for a patient with fluid volume excess
• C. A Kayexalate enema for a patient with severe hypokalemia
• D. An oil retention enema for a patient with constipation

Answer: (C)

The administration of a Kayexalate enema for a patient with severe hypokalemia should be questioned. Kayexalate is a medication used to treat hyperkalemia, not hypokalemia. It works by exchanging sodium for potassium in the intestines, thereby lowering potassium levels in the blood. In cases of severe hypokalemia, introducing Kayexalate could exacerbate the patient's electrolyte imbalance, potentially worsening their condition. In contrast, the other scenarios presented involve appropriate use of enemas for the respective conditions. For instance, a normal saline enema can safely be repeated every 4 hours to help stimulate bowel movements, particularly in a controlled situation where fluid balance is maintained. A hypertonic solution enema should be carefully used in patients with fluid volume overload but is effective in stimulating defecation. An oil retention enema is also a well-established method for treating constipation, as it allows for the stool to soften and promotes easier passage.

The administration of a Kayexalate enema for a patient with severe hypokalemia should be questioned. Kayexalate is a medication used to treat hyperkalemia, not hypokalemia. It works by exchanging sodium for potassium in the intestines, thereby lowering potassium levels in the blood. In cases of severe hypokalemia, introducing Kayexalate could exacerbate the patient's electrolyte imbalance, potentially worsening their condition.

In contrast, the other scenarios presented involve appropriate use of enemas for the respective conditions. For instance, a normal saline enema can safely be repeated every 4 hours to help stimulate bowel movements, particularly in a controlled situation where fluid balance is maintained. A hypertonic solution enema should be carefully used in patients with fluid volume overload but is effective in stimulating defecation. An oil retention enema is also a well-established method for treating constipation, as it allows for the stool to soften and promotes easier passage.