Cystic Fibrosis Hesi case study: Peds

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What response reflects that the nurse values the principle of beneficence?

"I know this has to be a very scary and difficult time for you. What can I do to help you?"

Which statement by the nurse is correct?

"It is care such as the sweat test and DNA testing that the child received."

Which statement by the parents indicates a correct understanding of a proper nutritional protocol of a client with CF?

- Her diet should include more calories than an unaffected child. - Client should take vitamin A, D, E, and K supplementation along with her diet. - Her diet should consist of high fat, high protein, and unrestricted fats.

What actions should the nurse educator take to address this?

- Instruct the parents to perform chest physiotherapy (CPT) either 2 hours before meals or 2 hours after meals.. - Aerosolized medications should be administered before CPT. - Encourage "blowing" activities, such as bubbles or pinwheels.

If the client attends a daycare center, what should be shared with the daycare workers?

- Proper handwashing between care of the other children - Isolate the child from any children with upper respiratory infections - Correct techniques for performing chest physiotherapy.

At what rate should the nurse set the infusion pump?

34

Which action should the primary nurse implement first?

Assess the client and the child who received the wrong medication.

Which rationale best supports this referral?

Community resources often provide support groups for parents of children with CF.

Which instruction should the nurse educator give the client's parents concerning the use of pancreatic enzymes as an oral prescription?

Ensure that enzymes are administered within 30 minutes of consuming meals and snacks

What action should the charge nurse take?

Explain that play therapy is an intervention and should not be interrupted for vital signs.

What is the CNS's responsibility when discussing immunizations?

Explain that the client should receive all routine childhood immunizations.

Based on her previous conversation with the mother, what is the best statement by the nurse?

I will sit with your child so you and your wife can talk. We have a quiet room you can use that is private and close by.

What information will the nurse include when teaching about the sweat test?

It is a simple and reliable test that measures the chloride in sweat.

The parents have been at the client's bedside since she was admitted to the hospital. The father asks to speak to the nurse outside in the hall. He tells the nurse that the mother is telling everyone that the client is going to be fine and that there has just been a mistake and everything will be all right. What action should the nurse take first?

Make arrangements to meet privately at the first opportunity.

The nurses recognize that energy needs are increased as a result of malabsorption of nutrients and that extra effort is needed for respirations and frequent pulmonary infections. The nurse teaches the client's parents about pancreatic replacement enzymes. Which of the following statements by the parents would indicate a correct understanding of the teaching?

Pancreatic enzymes are needed to digest fats and proteins.

Which action indicates to the nurse educator that the parents need more instruction about the respiratory care of the child with CF complications?

Placing the client in a prone position when she is having a dyspneic episode.

How should the CNS respond?

Suggest that they add extra salt to Darla's diet and watch her for dehydration.

While discussing pancreatic enzymes, the CNS explains that the dosage of the pancreatic enzyme is adjusted according to stool formation, which indicates how well client is digesting her food. Which adjustment would the nurse anticipate will be required, if client has constipation?

The pancreatic enzymes would be increased with each meal and snack.

What nursing task can be safely delegated to the UAP?

Taking vital signs.

Which statement should the nurse record as the expected outcome for this nursing problem?

The client will be able to remove mucus from the airway by coughing.

What information provided by the nurse is correct?

The second immunization is given between ages 4 and 6 years of age.

Which assessment supports the diagnosis of CF?

Weight loss and delayed growth despite a hearty appetite.

What laboratory result warrants immediate intervention?

White blood cell count (WBC) is 20,000/mcL (20 x 109/L).

Which documentation further supports the diagnosis of CF?

-A history of frequent respiratory infections. -Bulky loose stools

Which intervention should the nurse implement first?

Administer oxygen 4L/min via high-flow nasal cannula.

Which is the best explanation for the nurse to provide to the student?

Standards of care are published statements that describe the level of care that the client can expect from nurses.


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