A nurse is teaching a client who has a new prescription for pancrelipase to aid in digestion. The nurse should inform the client to expect which of the following gastrointestinal changes?
Decreased fat in stools
Decreased watery stools
Decreased mucus in stools
Decreased black tarry stools
The Correct Answer is A
Choice A: Decreased fat in stools
Pancrelipase is a combination of digestive enzymes, including lipase, protease, and amylase, which help break down fats, proteins, and carbohydrates. One of the primary benefits of pancrelipase is its ability to improve fat digestion and absorption. Clients with pancreatic insufficiency often experience steatorrhea, which is the presence of excess fat in stools, making them bulky, greasy, and foul-smelling. By aiding in the digestion of fats, pancrelipase reduces the fat content in stools, leading to more normal bowel movements.
Choice B: Decreased watery stools
While pancrelipase can improve overall digestion, it is not specifically known for decreasing watery stools. Watery stools can result from various conditions, including infections, inflammatory bowel disease, or other gastrointestinal disorders. Pancrelipase primarily targets the digestion of macronutrients and may not directly affect the consistency of stools unless the watery stools are due to malabsorption of fats.
Choice C: Decreased mucus in stools
Mucus in stools can be a sign of inflammation or irritation in the gastrointestinal tract, often associated with conditions like irritable bowel syndrome (IBS) or infections. Pancrelipase does not specifically target mucus production in the intestines. Its primary function is to aid in the digestion of fats, proteins, and carbohydrates, rather than addressing mucus-related issues.
Choice D: Decreased black tarry stools
Black tarry stools, also known as melena, are typically a sign of gastrointestinal bleeding, particularly from the upper GI tract. This condition requires immediate medical attention and is not related to the use of pancrelipase. Pancrelipase is not indicated for treating or preventing gastrointestinal bleeding and would not affect the presence of black tarry stools.
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Correct Answer is D
Explanation
Choice A reason: A client who has Guillain-Barré syndrome:
Guillain-Barré syndrome (GBS) can cause significant muscle weakness and paralysis, including the muscles involved in swallowing. Clients with GBS are at high risk for aspiration and may require specialized feeding techniques or assistance from a nurse rather than an AP.
Choice B reason: A client who has systemic sclerosis:
Systemic sclerosis, also known as scleroderma, can affect the esophagus and cause difficulty swallowing. These clients may need careful monitoring and assistance with meals to prevent choking and ensure adequate nutrition.
Choice C reason: A client who has amyotrophic lateral sclerosis (ALS):
ALS affects the motor neurons and can lead to progressive muscle weakness, including the muscles involved in swallowing. Clients with ALS often require specialized feeding techniques and close monitoring during meals to prevent aspiration.
Choice D reason: A client who has a lumbosacral spinal tumor:
A lumbosacral spinal tumor primarily affects the lower back and may cause pain or mobility issues, but it does not typically impair swallowing. Therefore, this client is the most appropriate for the AP to assist with meals, as they are less likely to have complications related to eating.
Correct Answer is B
Explanation
Choice A reason: Turn the client every 4 hours:
Regularly turning the client can help prevent pressure ulcers and improve overall circulation, but it is not the most effective measure specifically for preventing ventilator-associated pneumonia (VAP). While repositioning can help with lung expansion and secretion clearance, oral care is more directly related to reducing VAP risk.
Choice B reason: Brush the client’s teeth with a suction toothbrush every 12 hours:
Oral care is crucial in preventing VAP. Bacteria from the mouth can easily travel to the lungs, especially in intubated patients. Using a suction toothbrush helps remove dental plaque and secretions, reducing the bacterial load and the risk of infection. This practice is a key component of VAP prevention bundles.
Choice C reason: Provide humidity by maintaining moisture within the ventilator tubing:
While maintaining humidity is important to prevent drying of the respiratory mucosa and to help with secretion clearance, it does not directly reduce the risk of VAP. Proper humidification is necessary for patient comfort and respiratory function but is not a primary VAP prevention strategy.
Choice D reason: Position the head of the client’s bed in the flat position:
Positioning the head of the bed flat can increase the risk of aspiration, which is a significant risk factor for VAP. The head of the bed should be elevated to 30-45 degrees to reduce the risk of aspiration and promote better lung expansion.
