The nurse is interviewing the mother of an infant. She reports, "I had a difficult delivery, and my baby was born prematurely." This information should be recorded under which heading?

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: "Salt restriction."

Choice A rationale:

The requirement of a high protein diet is not typically indicated for a child with nephrosis. Nephrosis, a condition characterized by excessive protein in the urine, indicates a need to reduce protein intake to alleviate kidney stress and proteinuria.

Choice B rationale:

A low fat diet is not a specific requirement for a child with nephrosis. The focus in nephrosis is primarily on protein and salt intake rather than fat content.

Choice C rationale:

Salt restriction is the correct requirement for a child with nephrosis. Nephrosis often leads to fluid retention and edema due to impaired kidney function. Restricting salt intake helps to reduce fluid retention and manage blood pressure.

Choice D rationale:

A high carbohydrate diet is not commonly prescribed for a child with nephrosis. While carbohydrates are a source of energy, they are not a primary consideration in managing nephrosis. The emphasis is more on protein and salt intake.