The nurse is caring for a patient who has diabetes and complains of chronic, burning leg pain even when taking oxycodone (OxyContin) twice daily. Which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?

Choice A reason: This statement is true. Kayexalate is a medication that binds to potassium in the colon and exchanges it for sodium, thereby lowering the blood potassium level. It also has a laxative effect, which helps to eliminate the excess potassium in the stool.

Choice B reason: This statement is false. Kayexalate does not have a diuretic effect, which means it does not increase urine output or fluid loss. Diuretics are medications that act on the kidneys and help to remove excess fluid and sodium from the body.

Choice C reason: This statement is false. Kayexalate does not lower the blood sodium level, but rather increases it. This is because it exchanges potassium for sodium in the colon, which adds more sodium to the bloodstream.

Choice D reason: This statement is false. Kayexalate does not cause diarrhea, but rather a laxative effect, which means it stimulates bowel movements and softens the stool. Diarrhea is a condition where the stool is watery and frequent, and can cause dehydration and electrolyte imbalance.

Choice A reason: Burning pain and tingling in extremities are not symptoms of autonomic neuropathy, but of peripheral neuropathy. Peripheral neuropathy affects the sensory and motor nerves that innervate the skin, muscles, and joints. It can cause pain, numbness, weakness, and loss of sensation in the extremities. Autonomic neuropathy affects the nerves that control the involuntary functions of the body, such as digestion, blood pressure, heart rate, and sweating.

Choice B reason: Nausea and feeling of abdominal fullness are symptoms of autonomic neuropathy, specifically of gastroparesis. Gastroparesis is a condition where the stomach muscles are weakened or paralyzed, and cannot move food properly. It can cause delayed gastric emptying, nausea, vomiting, bloating, early satiety, and poor blood glucose control. Autonomic neuropathy can damage the vagus nerve, which regulates the stomach motility and secretion.

Choice C reason: Elevated blood pressure and delayed capillary refill are not symptoms of autonomic neuropathy, but of cardiovascular problems. Blood pressure is the force of blood against the walls of the arteries, and capillary refill is the time it takes for the color to return to the nail bed after pressing on it. Elevated blood pressure can indicate hypertension, which is a risk factor for heart disease and stroke. Delayed capillary refill can indicate poor blood circulation, which can be caused by atherosclerosis, peripheral artery disease, or shock. Autonomic neuropathy can affect the blood pressure and heart rate, but usually causes hypotension and tachycardia, not hypertension and delayed capillary refill.

Choice D reason: Increased thirst and excessive urination are not symptoms of autonomic neuropathy, but of diabetes mellitus. Diabetes mellitus is a condition where the body cannot produce or use insulin properly, and the blood glucose level becomes too high. Increased thirst and excessive urination are signs of hyperglycemia, which is a high blood glucose level. Hyperglycemia can cause dehydration, electrolyte imbalance, and ketoacidosis. Autonomic neuropathy can be a complication of diabetes mellitus, but it does not cause increased thirst and excessive urination.