What serum electrolyte level is a concern that may prompt the prescription of sodium polystyrene sulfonate in a client with acute kidney injury?

The concern for prescribing sodium polystyrene sulfonate, commonly known as Kayexalate, centers around elevated serum potassium levels, especially in a patient with acute kidney injury (AKI). In this condition, the kidneys are unable to effectively filter and excrete potassium, leading to hyperkalemia, which is a potentially life-threatening electrolyte imbalance.

A serum potassium level of 5.9 mEq/L is significantly elevated. Normal potassium levels range from about 3.5 to 5.0 mEq/L, and levels above 5.0 mEq/L indicate hyperkalemia. The risk factors associated with AKI, including the decreased ability to eliminate potassium, can cause levels to rise substantially. Immediate management is crucial, as high potassium levels can lead to serious complications such as cardiac arrhythmias or even cardiac arrest.

Sodium polystyrene sulfonate works by exchanging sodium ions for potassium ions in the intestines, thus helping to reduce the body's potassium levels. In summary, the elevated potassium level at 5.9 mEq/L indicates a significant risk for serious health complications and justifies the use of sodium polystyrene sulfonate for treatment.