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 ["A","B","C","E"]
Explanation
Choice A: Evaluate for the presence of a Babinski reflex
The Babinski reflex, also known as the plantar reflex, is a normal reflex in infants up to 2 years old. When the sole of the foot is stroked, the big toe moves upward, and the other toes fan out. This reflex helps assess the neurological function and integrity of the corticospinal tract. In the context of a subdural hematoma, evaluating the Babinski reflex can help determine if there is any neurological impairment or increased intracranial pressure, which could indicate worsening of the condition.
Choice B: Measure the head circumference
Measuring the head circumference is crucial in infants, especially those with head injuries, as it helps monitor brain growth and detect any abnormal swelling or increased intracranial pressure. An increase in head circumference can indicate the presence of intracranial bleeding or edema, which requires immediate medical attention. Regular monitoring of head circumference allows healthcare providers to track the infant’s neurological development and identify any deviations from the normal growth curve.
Choice C: Assess the pupillary reaction to light
Assessing the pupillary reaction to light is an essential neurological assessment in infants with head injuries. The pupils’ response to light provides information about the function of the optic nerve and the brainstem. A normal pupillary reaction indicates that the brainstem is functioning correctly, while an abnormal reaction can suggest increased intracranial pressure or brain injury. In this case, the nurse should assess the pupillary reaction to ensure there are no signs of neurological deterioration.
Choice D: Encourage parents to feed the infant
Encouraging parents to feed the infant is not recommended in this scenario. The infant’s inability to awaken for feeding and sleeping through the vital sign assessment could indicate a decreased level of consciousness or neurological impairment. Feeding an infant in such a state could increase the risk of aspiration and further complications. Instead, the nurse should focus on monitoring the infant’s neurological status and ensuring their safety.
Choice E: Palpate fontanel level
Palpating the fontanel level is an important assessment in infants with head injuries. The fontanels, or soft spots on the infant’s skull, provide valuable information about intracranial pressure. A bulging fontanel can indicate increased intracranial pressure, while a sunken fontanel may suggest dehydration. In this case, the nurse should palpate the fontanel to assess for any abnormalities that could indicate changes in the infant’s condition.
Correct Answer is B
Explanation
Choice A reason: Creatinine:
Creatinine is a waste product produced by muscles and is filtered out of the blood by the kidneys. Elevated creatinine levels can indicate kidney dysfunction. However, in this scenario, the primary concern is liver damage due to the combination of alcohol and acetaminophen, making AST a more relevant marker.
Choice B reason:Aspartate aminotransferase (AST):
AST is an enzyme found in the liver and heart. Elevated levels of AST can indicate liver damage. Given the client’s high intake of both alcohol and acetaminophen, there is a significant risk of liver damage. Monitoring AST levels can help assess the extent of liver injury.
Choice C reason:Amylase:
Amylase is an enzyme produced by the pancreas and salivary glands that helps in the digestion of carbohydrates. Elevated amylase levels are typically associated with pancreatic disorders, such as pancreatitis. While important, it is not the priority in this case where liver damage is the main concern.
Choice D reason: Antidiuretic hormone (ADH):
ADH is a hormone that helps regulate water balance in the body by controlling the amount of water reabsorbed by the kidneys. Abnormal levels of ADH can indicate issues with fluid balance, but it is not directly related to liver function or the effects of alcohol and acetaminophen.