Pediatric Nursing
Respiratory
Cystic Fibrosis - Pancreatic Enzymes
Test Id: 52270385
Question Id: 30371 (729561)
1 of 36
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The mother of a
... [Show More] 6-year-old child with cystic fibrosis (CF) has received instruction on the
use of pancreatic enzymes. Which statement made by the mother indicates a need for
further teaching?
Unordered Options Ordered Response
1. "I need to monitor the total amount of this medication that I give
to my child every day."
2. "I should give this medication with or just before my child has a
meal or snack."
3. "It is okay for my child to chew this medication."
4. "It is okay to open the capsule and sprinkle the medicine on a
tablespoon of applesauce."
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Last Updated: 10/31/2015
Explanation In CF, unusually thick mucus obstructs the pancreatic ducts, preventing pancreatic
enzymes (amylase, trypsin, and lipase) from reaching the small intestine. The result is
malabsorption of carbohydrates, fats, and proteins; the inability to absorb fat-soluble
vitamins (A, D, E, and K) is of particular concern. Gastrointestinal signs and symptoms
of CF include flatulence, abdominal cramping, ongoing diarrhea, and/or steatorrhea.
Nutritional therapy includes the administration pancreatic enzyme supplements with or
just before every meal or snack (Option 2). These enzymes are enteric-coated
beads designed to dissolve only in an alkaline environment similar to that of the small
intestine. They must not be mixed with a substance that would cause them to dissolve
prior to reaching the jejunum. Capsule contents may be sprinkled on applesauce,
yogurt, or acidic, soft, room-temperature foods with pH <4.5. Capsules should be
swallowed whole and not crushed or chewed; chewing the capsules could cause
irritation of the oral mucosa. Excessive intake of pancreatic enzymes can result in
fibrosing colonopathy (Option 1).
(Option 4) This is a true statement; some children have difficulty taking a whole
capsule. Capsule contents can be sprinkled in acidic substances such as applesauce.
Capsules should not be taken with milk as they can cause it to curdle. [Show Less]