A nurse is caring for a client with an elevated serum potassium level of 6.0 mEq/L (3.5-5.0 mEq/L). Which scheduled medication should the nurse plan to administer?

Choice A reason: Sertraline is an antidepressant, specifically a selective serotonin reuptake inhibitor (SSRI). It is typically used to treat conditions like depression, anxiety disorders, and obsessive-compulsive disorder. While it is an effective medication for these conditions, it has no role in the management of elevated serum potassium levels. Administering sertraline to a patient with hyperkalemia would not address the critical need to lower potassium levels, making it an unsuitable option for this scenario. Hyperkalemia requires prompt intervention with medications that directly lower potassium or aid in its excretion. Choice B reason: Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly prescribed to treat hypertension and heart failure. While it can be an effective medication for these conditions, captopril is contraindicated in patients with elevated potassium levels. ACE inhibitors can increase serum potassium levels, thereby exacerbating hyperkalemia. For a patient already experiencing an elevated serum potassium level of 6.0 mEq/L, administering captopril could worsen the condition, potentially leading to severe cardiac complications. Choice C reason: Digoxin is a cardiac glycoside used primarily to treat heart failure and atrial fibrillation. Although it has significant therapeutic value in managing certain heart conditions, digoxin does not have any effects on serum potassium levels. It neither reduces nor increases potassium levels significantly and is therefore not appropriate for the treatment of hyperkalemia. Administering digoxin would not help address the elevated potassium levels and could divert attention from more critical interventions needed to correct hyperkalemia. Choice D reason: Sodium polystyrene sulfonate is a cation-exchange resin that is specifically used to treat hyperkalemia. It works by binding to potassium in the gastrointestinal tract, which is then excreted through the feces. This process effectively lowers serum potassium levels. Given its mechanism of action and its specific indication for treating hyperkalemia, sodium polystyrene sulfonate is the appropriate choice for a patient with an elevated potassium level of 6.0 mEq/L. This medication addresses the root issue of hyperkalemia directly and is the most suitable option among the provided choices for managing elevated serum potassium levels.