A nurse is administering pancrelipase to a child who has cystic fibrosis. Which of the following outcomes should the nurse expect as a therapeutic effect of the treatment?
A.
Improved respiratory function
B.
Decreased sodium excretion
C.
Improved absorption of vitamins B and C
D.
Reduced fat in the stools
The Correct Answer and Explanation is:
The correct answer is D. Reduced fat in the stools.
Pancrelipase is an enzyme replacement therapy prescribed for individuals with cystic fibrosis (CF) to aid in digestion, particularly fat digestion. Cystic fibrosis is a genetic disorder that primarily affects the lungs and the digestive system, particularly the pancreas. The thick, sticky mucus characteristic of CF can block the pancreatic ducts, preventing the secretion of digestive enzymes necessary for breaking down fats, proteins, and carbohydrates in the small intestine. This results in malabsorption, especially of fats, which leads to steatorrhea, a condition characterized by fatty, bulky stools.
Pancrelipase contains lipase, protease, and amylase, which are enzymes that assist in the digestion of fats, proteins, and carbohydrates, respectively. By supplementing these enzymes, pancrelipase allows for the proper breakdown of dietary nutrients, particularly fats. This improved digestion of fats reduces the fat content in stools, alleviating the steatorrhea experienced by many individuals with CF.
Therapeutic Outcome:
The primary therapeutic outcome of administering pancrelipase is the improvement of fat digestion, resulting in reduced fat in the stools. This not only decreases the occurrence of fatty, foul-smelling stools but also improves the overall nutritional status of the child. Better nutrient absorption can lead to weight gain, improved growth, and enhanced energy levels, all of which are vital for children with CF, who often struggle with malnutrition due to malabsorption.
Why the Other Options Are Incorrect:
- A. Improved respiratory function: Pancrelipase targets digestive enzyme deficiency and has no direct effect on respiratory function. Respiratory improvements in CF are usually managed with airway clearance techniques, antibiotics, and inhaled medications.
- B. Decreased sodium excretion: Sodium and chloride balance is affected in CF, but pancrelipase does not influence sodium excretion. Sodium and chloride imbalances are treated through dietary adjustments and sometimes supplements.
- C. Improved absorption of vitamins B and C: Pancrelipase primarily helps in the absorption of fat-soluble vitamins (A, D, E, K). Vitamins B and C are water-soluble, and their absorption is not significantly affected by pancrelipase therapy.
In conclusion, the expected therapeutic effect of pancrelipase in children with CF is the reduction of fat in stools, thereby improving their nutritional absorption and quality of life.