Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. What should the nurse assess before administering the medications

A. Blood glucose: Monitoring blood glucose is important for patients receiving insulin and dextrose as treatment for hyperkalemia, but it is not directly related to sodium polystyrene sulfonate. Kayexalate works in the GI tract and does not typically affect glucose levels. B. Level of consciousness (LOC): Assessing LOC is always essential for safety, but it is not the priority before giving Kayexalate. The drug’s mechanism of action requires bowel function, so neurological status is not the most relevant factor in this situation. C. Bowel sounds: Kayexalate exchanges sodium for potassium in the colon and requires an intact, functioning bowel to be effective and safe. Absent bowel sounds may indicate ileus or obstruction, and giving the drug in this condition can cause severe complications such as intestinal necrosis. D. Blood urea nitrogen (BUN): BUN helps monitor renal function and fluid balance, but it does not determine the safety of Kayexalate administration. Although kidney disease may contribute to hyperkalemia, bowel function is the most critical assessment before giving this medication.