The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. What is the most appropriate initial nursing action?

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 D: Verbalizing the importance of monitoring for medication side effects.

Choice A rationale:

Allowing the adolescent to make decisions about whether or not to take medication is important, but it is not the priority nursing goal for a 14-year-old diagnosed with Graves' disease. The priority is ensuring proper medication management and monitoring to control the thyroid dysfunction and prevent potential complications.

Choice B rationale:

Relieving constipation might be a consideration, but it is not the priority nursing goal for a 14-year-old diagnosed with Graves' disease. The primary focus is on addressing the thyroid-related issues and providing appropriate education and support to the adolescent.

Choice C rationale:

Developing alternative educational goals is not the priority nursing goal for a 14-year-old diagnosed with Graves' disease. While education is important, the immediate concern is managing the medical condition and ensuring the adolescent's well-being.

Choice D rationale:

Verbalizing the importance of monitoring for medication side effects is the priority nursing goal for a 14-year-old diagnosed with Graves' disease. Graves' disease is a thyroid disorder that requires medication management, typically involving antithyroid medications or other interventions. Monitoring for medication side effects ensures the adolescent's safety and helps to prevent adverse reactions or complications. It also empowers the adolescent to be vigilant about their health and medication regimen.