CH 28 - Cystic Fibrosis and Bronchiectasis

Which condition may develop if severe pneumonia is left untreated? Atelectasis Hemoptysis Bronchiectasis Chronic bronchitis

Bronchiectasis A wide variety of infectious agents initiate bronchiectasis. It can follow a single episode of severe pneumonia or infection that either was not treated or received delayed treatment. Atelectasis is a complication of asthma due to hyperinflation of the lungs and increased dead space. Hemoptysis is a lung complication that occurs due to erosion of enlarged pulmonary arteries. Chronic bronchitis may be the initial stage of lung disorders.

Which treatment helps to degrade deoxyribonucleic acid of neutrophils in the sputum of a patient with cystic fibrosis (CF)? Dornase alfa Ciprofloxacin Aerosolized tobramycin Inhaled hypertonic saline (7%)

Dornase alfa Dornase alfa helps to degrade deoxyribonucleic acid of neutrophils in CF sputum. Ciprofloxacin helps to treat mild exacerbations. Aerosolized tobramycin increases lung function and prevents exacerbation frequency. Inhaled hypertonic saline (7%) clears mucus, promotes bronchodilation, and decreases the frequency of exacerbations.

Which action will the nurse take for a male patient with cystic fibrosis (CF) who states, "I hope that this condition allows me to have biologic children"? Educate the patient about assisted reproductive technology. Ask a case manager to provide the patient with information. Convey information about decreased production of sperm. Refer the patient to the health care provider for education.

Educate the patient about assisted reproductive technology. Men with CF may fail to develop vas deferens in utero. Therefore the sperm remain in the testes and do not pass through the penile urethra. The nurse may suggest assisted reproductive technology to the patient. The nurse should not depend on a case manager or the health care provider to teach the patient. Patients with CF have normal production of sperm despite having testosterone insufficiency.

Which change occurs with cystic fibrosis (CF)? Severe weight gain Increased inflation of lungs Increased ciliary movement Lower than normal level of salt in the sweat

Increased inflation of lungs CF affects both the upper and lower respiratory tracts. It affects the small airway first and progresses to the larger airways, finally passing into the lungs, causing hyperinflation of the lungs due to obstruction of the bronchioles by thick mucus that traps the air. A hallmark of CF in children is poor weight gain and growth. These children are unable to get enough nutrients from their food because of the lack of enzymes to help absorb fats and proteins. One of the first signs is a strong salty taste to the skin. This is the result of higher levels of salt present in the sweat. Parents of children with cystic fibrosis have mentioned tasting this saltiness when kissing their children. The mucus dehydrates and becomes thick due to decreased ciliary movement.

Which finding helps to diagnose cystic fibrosis (CF) in a newborn? Gallstone Liver cirrhosis Terminal ileus Meconium ileus

Meconium ileus The presence of meconium ileus helps to diagnose 20% of cases of CF in newborns. Gallstones and liver cirrhosis occur in some patients with CF. Liver cirrhosis occurs over time due to an accumulation of mucus in the liver of patients with cystic fibrosis. Terminal ileus does not indicate the presence of CF in the newborn.

Which test is the gold standard for diagnosing cystic fibrosis (CF)? Genetic test Lung biopsy Sweat chloride test Test for pancreatic insufficiency

Sweat chloride test The sweat chloride test is the most definitive test in children but may not be conclusive in adults. Patients with CF secrete four times the normal amounts of sodium and chloride in their sweat. Genetic tests may be used if the sweat test is inconclusive. A lung biopsy is not used to diagnose this condition. Pancreatic insufficiency is related to CF but does not specifically diagnose the disease.