Which of the following best describes the expected effect after a Kayexalate enema is administered for hyperkalemia?

• A. Diarrhea
• B. Constipation
• C. Nausea without bowel movement
• D. Urinary frequency

Answer: (A)

Kayexalate enema binds potassium in the large intestine and facilitates its excretion in the stool. Because this resin draws potassium into the stool, the expected effect is increased stool output, commonly loose or watery stools (diarrhea). This aligns with lowering the serum potassium by removing it via the GI tract. The other options don’t fit because constipation, nausea without bowel movement, or urinary frequency don’t reflect the resin’s action in the colon. Monitor for dehydration and electrolyte shifts, and be aware of the rare risk of intestinal necrosis, especially if used with sorbitol or in patients with GI tract issues.