Question

A client with cystic fibrosis is taking pancreatic enzymes. The nurse should administer this medication: A. Once per day in the morning B. Three times per day with meals C. Once per day at bedtime D. Four times per day

Short answer

Answer: The appropriate administration of pancreatic enzymes for a patient with cystic fibrosis is three times per day with meals. This ensures that the enzymes work effectively with the food being consumed, breaking down fats, proteins, and carbohydrates for better absorption by the body.

Step-by-step solution

Understanding the problem (cystic fibrosis and pancreatic enzymes)

Cystic fibrosis is a genetic disorder that affects the lungs and digestive system. Pancreatic enzymes are medications prescribed to these patients as their pancreas may not produce enough enzymes needed for proper digestion. These enzymes help break down fats, proteins, and carbohydrates in food so that they can be absorbed by the body.

Reading the question carefully and understanding the options

The question asks for the appropriate administration of pancreatic enzymes for a patient with cystic fibrosis. There are four options given: A. Once per day in the morning, B. Three times per day with meals, C. Once per day at bedtime, and D. Four times per day. We need to identify which option is the correct way to administer these enzymes.

Identifying the correct answer

The key insight is that pancreatic enzymes must be taken with meals to ensure that they work effectively with the food being consumed. Thus, option B (three times per day with meals) is the correct answer. This is because the enzymes must be taken during or right before eating to break down nutrients efficiently and help the patient's digestive system. Administering the medication once per day in the morning (Option A), once per day at bedtime (Option C) or four times per day (Option D) without mentioning the relationship with meal times would not be as effective in managing the symptoms of cystic fibrosis.

Providing a brief explanation for the answer

The pancreatic enzymes should be administered three times per day with meals (option B) to effectively assist digestion in cystic fibrosis patients. Taking these enzymes during or right before mealtime allows them to work properly with the food consumed, breaking down fats, proteins, and carbohydrates for better absorption by the body.

Key concepts

Understanding Cystic Fibrosis

Cystic fibrosis (CF) is a hereditary disorder with widespread effects on the body, but most notably the lungs and digestive system. It's caused by mutations in the CFTR gene, which normally regulates salt and water movement in and out of cells. In people with cystic fibrosis, thick, sticky mucus clogs airways and creates a fertile ground for bacteria to grow, leading to repeated lung infections.

This excessive mucus production also impairs the pancreas, preventing the release of digestive enzymes that are necessary for breaking down food and absorbing vital nutrients. As a result, individuals with CF often struggle with malnutrition, vitamin deficiencies, and delayed growth.

Regular monitoring, lung function tests, and daily treatments including chest physical therapy and medications are essential. Ensuring proper nutritional intake is another key aspect of managing CF. Therefore, it's crucial for individuals with CF to have a tailored diet plan and to take prescribed supplements or enzymes to aid digestion.

Pancreatic Enzymes Administration

Pancreatic enzymes are a cornerstone treatment for patients with cystic fibrosis. These medications compensate for the impaired enzyme production by the pancreas, allowing for the digestion and absorption of fats, proteins, and carbohydrates.

To mimic the body's natural process, the enzymes must be consumed with food, typically at the beginning of each meal and snack. This ensures that the enzymes are present in the small intestine as the food arrives for digestion.

Dosage and Timing

The specific dosage and strength of the enzymes are based on the individual's weight, diet, degree of pancreatic insufficiency, and overall health. Taking these enzymes three times per day with meals allows them to integrate with the dietary intake and work efficiently. Therefore, option B from the NCLEX-PN practice question is correct. It is essential for nurses to teach patients and families the importance of this timing to optimize the benefit of the enzymes.

Nursing Medication Management

Medication management is a critical skill for nurses, especially in the treatment of chronic conditions like cystic fibrosis. Nurses must be meticulous in explaining how to take medications correctly to ensure therapeutic effectiveness and minimize potential side effects or interactions.

For pancreatic enzyme administration, the nurse should guide the patient to take the medication as directed, most importantly with meals. In addition to administering medication, nurses should assess the patient's understanding of their treatment plan, monitor for efficacy and side effects, and provide education on lifestyle modifications that can support medication effectiveness.

By focusing on patient-centered care, nurses play a vital role in the medication management process, thereby improving patient outcomes and enhancing the quality of life for those living with chronic illnesses such as cystic fibrosis.