The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?

The correct answer is choice A: Administer pancreatic enzymes between meals if at all possible.

Choice A rationale:

Administer pancreatic enzymes between meals if at all possible. This is the correct choice. When educating the parents and child with cystic fibrosis about the administration of pancreatic enzymes, it's important to emphasize that these enzymes should be given between meals whenever feasible. Administering them between meals, when the stomach is less acidic and less likely to release the enzymes prematurely, ensures optimal digestion of food and absorption of nutrients. This approach aligns with the physiological need to supplement pancreatic enzyme function due to the inadequate natural enzyme production in cystic fibrosis.

Choice B rationale:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal. This choice is a valid option for administering pancreatic enzymes. While it's true that the enzymes can be taken either by swallowing the capsules whole or by opening them and sprinkling the contents on a small amount of food at the start of a meal, this method can vary based on individual preferences and abilities. However, the primary focus should be on timing (between meals) to achieve the best enzymatic action.

Choice C rationale:

Do not administer pancreatic enzymes if the child is receiving antibiotics. This statement is not accurate. There is no general contraindication to administering pancreatic enzymes while a child is on antibiotics. However, it's important for the healthcare provider to be aware of all the medications the child is taking to ensure there are no potential drug interactions or effects on absorption. Always consult with the healthcare team before adjusting the administration of any medication.

Choice D rationale:

Decrease the dose of pancreatic enzymes if the child is having frequent, bulky stools. This statement is not consistent with typical practice. If a child is experiencing frequent, bulky stools, it may actually indicate that the pancreatic enzyme dosage needs adjustment (increasing the dose rather than decreasing). Bulky stools can suggest poor digestion and absorption, which might require more enzymes to properly break down nutrients. Dosage adjustments should always be made under the guidance of the healthcare provider based on factors such as stool consistency, weight gain, and nutritional status.

The correct answer is Choice C: Epispadias.

Choice A rationale:

Chordee is not the correct term to identify when the meatal opening is located on the dorsal surface of the penis. Chordee refers to the downward curvature or bending of the penis, often associated with hypospadias or other congenital conditions.

Choice B rationale:

Hypospadias is not the correct term for this condition. Hypospadias refers to a congenital condition where the opening of the urethra is located on the underside of the penis rather than at the tip. It is not related to the meatal opening being on the dorsal surface.

Choice C rationale:

Epispadias. This is the correct choice. Epispadias is a congenital malformation where the meatal opening is located on the dorsal (upper) surface of the penis. It is a rare condition and requires surgical intervention for correction.

Choice D rationale:

Phimosis is not the correct term for this condition. Phimosis refers to the tightness of the foreskin that prevents it from being pulled back over the tip of the penis. It does not relate to the positioning of the meatal opening.