A nurse is teaching an adolescent about smoking cessation. Which of the following statements should the nurse include in the teaching?

Cystic fibrosis is an inherited disorder that affects the exocrine glands, causing thick secretions in the lungs, pancreas, and gastrointestinal tract. Pancreatic enzyme deficiency commonly occurs because thick mucus blocks pancreatic ducts, preventing digestive enzymes from reaching the intestines. This leads to malabsorption of fats, proteins, and fat-soluble vitamins. Home management includes nutritional support, pancreatic enzyme replacement, adequate fluids, and increased salt intake.

Rationale:
A. Restricting sodium is incorrect because children with cystic fibrosis lose excessive sodium and chloride through sweat due to abnormal chloride channel function. They are at increased risk for dehydration and electrolyte imbalance, especially during hot weather or exercise. These children usually require increased salt intake rather than sodium restriction.

B. Pancreatic insufficiency prevents proper digestion and absorption of nutrients, especially fats and proteins. Enzyme replacement must be given with all meals and snacks to improve digestion, promote weight gain, and reduce symptoms such as steatorrhea and malnutrition. This is a key part of long-term cystic fibrosis management.

C. Preparing low-fat meals with limited protein is incorrect because children with cystic fibrosis require a high-calorie, high-protein, and often high-fat diet to support growth and compensate for malabsorption. Restricting fat and protein would worsen nutritional deficiencies and poor weight gain. Nutritional intake should be increased, not limited.

D. Limiting daily fluid intake is incorrect because adequate hydration is essential to help thin respiratory secretions and reduce the risk of mucus plugging. Children with cystic fibrosis are also prone to fluid loss through excessive sweating. Increased fluid intake supports airway clearance and helps maintain proper hydration status.

Acute sickle cell crisis occurs when sickled red blood cells obstruct microcirculation, leading to tissue ischemia, severe pain, and potential organ damage. Triggers include dehydration, hypoxia, infection, and stress. Nursing management focuses on relieving pain, improving oxygen delivery, and reducing blood viscosity. Adequate hydration is a key intervention because it helps decrease blood viscosity and promotes better circulation through the microvasculature.

Rationale:
A. Administering multiple units of platelets is not indicated in sickle cell crisis because the primary problem is vaso-occlusion by sickled red blood cells, not thrombocytopenia or platelet dysfunction. Platelet transfusion does not address the underlying pathophysiology and is not part of standard management.

B. Preparing to administer potassium IV bolus is inappropriate because potassium supplementation is not a treatment for sickle cell crisis and may be dangerous if not indicated. IV potassium is reserved for documented hypokalemia and must be administered cautiously due to the risk of cardiac dysrhythmias.

C. Providing hydration orally and IV is essential because increased fluid volume reduces blood viscosity and helps prevent further sickling of red blood cells. Adequate hydration improves circulation, supports tissue perfusion, and helps decrease pain associated with vaso-occlusion. This is a cornerstone of acute crisis management.

D. Requesting a prescription for meperidine is inappropriate because this opioid is not recommended for sickle cell pain management due to its neurotoxic metabolite, normeperidine, which can cause seizures. Safer opioid options such as morphine or hydromorphone are preferred for controlling severe pain in sickle cell crisis.