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 C
Explanation
Choice A: Tell the client to expect dark stools following chemotherapy
Dark stools are not a common side effect of chemotherapy. This symptom is more often associated with gastrointestinal bleeding or the use of certain medications, such as iron supplements or bismuth-containing compounds. Chemotherapy can cause a range of side effects, but dark stools are not typically one of them. Therefore, it is not necessary to inform the client to expect this symptom.
Choice B: Have the client swish with commercial mouthwash before therapy
While maintaining oral hygiene is important during chemotherapy, using a commercial mouthwash before therapy is not specifically recommended. Some commercial mouthwashes contain alcohol or other irritants that can exacerbate oral mucositis, a common side effect of chemotherapy. Instead, clients are often advised to use a gentle, alcohol-free mouthwash or a saline rinse to maintain oral hygiene and prevent infections.
Choice C: Administer an antiemetic prior to the procedure
Administering an antiemetic prior to chemotherapy is a standard practice to prevent nausea and vomiting, which are common side effects of many chemotherapeutic agents. Antiemetics help to improve the client’s comfort and adherence to the treatment regimen by reducing these distressing symptoms. This proactive approach is crucial in managing the side effects of chemotherapy and ensuring that the client can tolerate the treatment.
Choice D: Have the client floss 4 times daily
Flossing is an important part of oral hygiene, but flossing 4 times daily is excessive and can cause irritation or damage to the gums, especially in clients undergoing chemotherapy who may have a higher risk of oral mucositis and bleeding. It is generally recommended to floss once daily and to use a soft-bristled toothbrush to maintain oral health without causing additional trauma.
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.