A 6 year old who exhibits a moist, productive cough has a history of bronchitis several times every year and "eating everything in sight.". She appears thin for her age and has a sweat chloride test that is 67 mEQ/L
Her mother states, "I just want to get this eating disorder treated so my baby can have a normal life.". What is the nurse's best response? 1. "We will consult the dietician for a behavior management and eating plan, focusing on appropriate portion size.".
2. "We will need to do another sweat chloride test next week. Have your child take supplemental water-soluble vitamins, such as A, D, K and iron.".
3. "You should incorporate tofu and mayonnaise in your meal preparation to promote feeling full for a longer period of time.".
4. "Cystic fibrosis can cause an increase in appetite because of the lack of nutrients and calories absorbed. This affects children across the life span.".
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Feedback
1. Food choices that contain the needed vitamins and minerals should be discussed.
2. The child already has the diagnosis and another test will not indicate which vitamins to give.
3. This diet will not easily be digested by a person with CF. The menu should be reconsidered.
4. Increased appetite is a physiologic response to decreased fat-soluble nutrients and calories absorbed in the CF digestive track. This requires fat-soluble (A,D, E, K) vitamins and pancreatic enzyme supplements.
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