A patient in the clinic with cystic fibrosis (CF) reports ...

[serike]

A patient in the clinic with cystic fibrosis (CF) reports increased sweating and weakness during the summer months. Which action by the nurse would be most appropriate?
 
  a. Have the patient add dietary salt to meals.
  b. Teach the patient about the signs of hypoglycemia.
  c. Suggest decreasing intake of dietary fat and calories.
  d. Instruct the patient about pancreatic enzyme replacements.

Question 2

A young adult patient with cystic fibrosis (CF) is admitted to the hospital with increased dyspnea. Which intervention should the nurse include in the plan of care?
 
  a. Schedule a sweat chloride test.
  b. Arrange for a hospice nurse visit.
  c. Place the patient on a low-sodium diet.
  d. Perform chest physiotherapy every 4 hours.

[qytan]

Answer to Question 1

ANS: A
Added dietary salt is indicated whenever sweating is excessive, such as during hot weather, when fever is present, or from intense physical activity. The management of pancreatic insufficiency includes pancreatic enzyme replacement of lipase, protease, and amylase (e.g., Pancreaze, Creon, Ultresa, Zenpep) administered before each meal and snack. This patient is at risk for hyponatremia based on reported symptoms. Adequate intake of fat, calories, protein, and vitamins is important. Fat-soluble vitamins (vitamins A, D, E, and K) must be supplemented because they are malabsorbed. Use of caloric supplements improves nutritional status. Hyperglycemia due to pancreatic insufficiency is more likely to occur than hypoglycemia.

Answer to Question 2

ANS: D
Routine scheduling of airway clearance techniques is an essential intervention for patients with CF. A sweat chloride test is used to diagnose CF, but it does not provide any information about the effectiveness of therapy. There is no indication that the patient is terminally ill. Patients with CF lose excessive sodium in their sweat and require high amounts of dietary sodium.