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 B
Explanation
Choice A: Induce Sedation
Pancuronium is not used to induce sedation. It is a neuromuscular blocking agent (NMBA) that causes paralysis of skeletal muscles. Sedation is typically achieved using medications such as benzodiazepines or propofol, which act on the central nervous system to produce a calming effect.
Choice B: Suppress Respiratory Effort
Pancuronium is used to suppress respiratory effort in patients with ARDS who require mechanical ventilation. By causing muscle paralysis, pancuronium helps to synchronize the patient’s breathing with the ventilator, reducing the risk of ventilator-induced lung injury and improving oxygenation. This is particularly important in severe cases of ARDS where patient-ventilator dyssynchrony can be detrimental.
Choice C: Decrease Chest Wall Compliance
Decreasing chest wall compliance is not a purpose of pancuronium. In fact, pancuronium does not directly affect chest wall compliance. Instead, it works by blocking the transmission of nerve impulses to the muscles, leading to muscle relaxation and paralysis.
Choice D: Decrease Respiratory Secretions
Pancuronium does not decrease respiratory secretions. Medications such as anticholinergics (e.g., atropine) are used to reduce secretions. Pancuronium’s primary role is to facilitate mechanical ventilation by ensuring complete muscle relaxation.
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.