QUIZ 2 NCM 109 LECTURE

Applying your knowledge (5 points each)

Case Study:
Rebecca is a 2-year-old with cystic fibrosis. Her mother is a working single parent. Rebecca was
admitted to the pedia ward with a diagnosis of pneumonia. Her mother expresses concern that
Rebecca will die because working makes it difficult for her to perform the respiratory care
Rebecca requires.

1. What are the major problems you would address for Rebecca during her hospital stay?

I will address Rebecca’s mother in an appropriate way and explain her about her
daughter’s condition that:

 Cystic fibrosis is a lifelong condition that causes severe damage to the respiratory and
digestive systems. Your mucus, tears, sweat, and saliva become so thick and sticky that
they clog your lungs and digestive system. The most commonly affected organs include
the: lungs, pancreas, liver and intestines.

 It usually causes problems with breathing and with breaking down and absorbing food.
Cystic fibrosis is a genetic disorder. If your parents or close relatives have Cystic
fibrosis, there is a higher risk that you may have it.

 It also affects the cells that produce sweat, mucus, and digestive enzymes. Normally,
these secreted fluids are thin and smooth like olive oil. They lubricate various organs
and tissues, preventing them from getting too dry or infected. In people with cystic
fibrosis, however, a faulty gene causes the fluids to become thick and sticky. Instead of
acting as a lubricant, the fluids clog the ducts, tubes, and passageways in the body.

 This can lead to life-threatening problems, including infections, respiratory failure, and
malnutrition. It’s critical to get treatment for cystic fibrosis right away. Early diagnosis and
treatment are critical for improving quality of life and lengthening the expected lifespan.

2. Your discharge plan would need to address what family needs?

Preventing infection
 Help keep your child's lungs clear of extra mucus. Learn how to do chest physical
therapy, including postural drainage and percussion on your child to help with this. Ask your
child's healthcare provider for instructions.
 Remind your child to wash his or her hands often, and correctly.
o He or she should use soap and water and a lot of rubbing.
 o Make sure you have alcohol-based hand cleaner when soap and water aren't
available.
o Teach your child to keep his or her hands away from the face. Germs often get
into the nose and mouth and then into the lungs this way.
 Ask your child's healthcare provider about a yearly flu shot and other vaccinations.
 Avoid crowds, especially in the winter, when more people have colds and the flu.

Aiding digestion
 Learn about the special dietary needs of your child. Your child may need pancreatic
enzymes to help with digestion.
 If prescribed, make sure your child takes pancreatic enzymes exactly as instructed.
 A nutritionist or dietitian can help you and your child. Ask your child's healthcare provider
for a referral.
 Some children have problems growing and gaining weight. Talk with your child's
healthcare provider or nutritionist about which types and amounts of foods or supplements
to include in your child's diet.

Other home care

 Encourage your child to exercise regularly and drink lots of fluids.
 Your child should see his or her healthcare provider at least every 3 months, or as
directed.
 Make sure you talk with your child about the dangers of smoking. He or she should not
smoke and should stay away from others who do.

Follow-up
Make all follow-up appointments as soon as possible after leaving the hospital. Contact your
child's healthcare provider sooner, if you have any questions or concerns.

Ask about the closes Cystic Fibrosis Center. These centers specialize in the care of children
and adults with cystic fibrosis.

When to call your child's healthcare provider

Call the healthcare provider right away if your child has any of the following:

 Severe constipation
 Severe diarrhea
 Abdominal pain
 Vomiting
 Decreased appetite
 More mucus than usual, or mucus that is bloody or dark in color
 Difficulty taking part in daily activities
 More tired than usual
 Fever
 Worsening shortness of breath

Since each child is different, make sure you understand when to call the healthcare provider
about your child's specific symptoms.

3. How might community agencies be beneficial in assisting Rebecca and her mother?

 LEARN. Ask if there is anything you can read to learn about CF. Use the internet to learn
more. The Cystic Fibrosis Foundation (www.cff.org) and the Boomer Esiason
Foundation (www.esiason.org) are good sites.

 GIVE EMOTIONAL SUPPORT. Ask what you can do to give support. Accept the pain
and sadness they may be feeling. They may be dealing with hope, denial, grief, and fear.

 DO NOT EXPOSE THE FAMILY TO ILLNESS. For those with CF, there is no such thing
as "just a cold." Viruses can have a much bigger impact. They can lead to more severe
infections for the child with CF. When you visit the family, wash your hands when you
enter their home. If the family with CF is coming to your house to visit, and someone in
your house is ill, don't wait until they get there to tell them. Call them. Give them the
option to stay home. Everyone in the family needs yearly flu shots.

 LEARN CF CARE. Daily CF care varies and may include enzymes, antibiotics, vitamins,
and other medications. Most children will need respiratory therapy, like the Vest™ or
chest physiotherapy (CPT). Ask questions. Have your loved ones show you how to give
enzymes, medications and respiratory therapy. Maybe you could care for the child and
let the parents rest. Don't neglect routine care like check-ups and immunizations.

 GIVE TO CF ORGANIZATIONS. Participate in CF fundraisers. By joining the search for

a cure, you give hope to the family and lessen their sense of aloneness.

 SPEAK OUT ABOUT CF. Most people have not heard of CF or know little about it.
Teach others about CF and the need to find a cure. Teach others about infection control.
Involve others in CF fundraisers. Be aware of government funding for medical research
at the National Institutes of Health and Public Assistance programs such as Medicaid,
Maternal and Child Health Programs, and Adult CF Programs.
 BE SENSITIVETO THE TYPE OF STORIES YOU SHARE WITH THE FAMILY. Families
hearing about people who have died from CF does not help. Lung transplants may
extend the life of a CF patient, but they are not a cure for CF.

What you can do is check your license to make sure you are an organ donor. While
parents must hope for the best for their child, they live with the fear of the worst. Think
about the impact of a CF-related story before you share it.

 TREAT KIDS WITH CF THE SAME AS OTHER KIDS. Children need to be treated
"normally." Be sensitive to their special needs and fears, but don't be too careful.
Children with CF need limits, just like their non-CF peers.

 EVERYONE'S CF IS UNIQUE. Some may have mild lung disease, others may be
hospitalized often for lung, sinus, liver, and GI problems. Many things decide the course
of the disease for each person.

 PAY ATTENTION TO SIBLINGS. The brothers and sisters of children with CF often feel
left out, due to the extra care that the child with CF needs. Some feel jealous of the time
parents spend with the other child doing treatments and going to appointments. Give
special time to the siblings to help them cope with their doubts and fears.

 WHEN THE CHILD WITH CF IS IN THE HOSPITAL, ASK HOW YOU CAN HELP. Call
before you visit, in case the child or parent is trying to rest. If you are sick, don't visit.
Don't bring your kids, if they are sick. Ask about special precautions before you visit.
Wash your hands when you enter the room. Offer to stay with the child so the parent can
rest. Arrange a play date for the sibling, who may be feeling left out. Help with shopping,
washing, and cleaning.

 DON'T SMOKE. People with CF work daily to slow lung damage. Do not expose a family
coping with CF to cigarette, cigar, or pipe smoke. Second-hand smoke is bad for all. For
people with CF, it's worse.

 SHOULD YOU BE TESTED TO SEE IF YOU CARRY CF? CF is a genetic disease. If

you are related by blood to someone with CF, it is possible that you can carry the gene.
If you're thinking about having children, knowing your status makes a difference. Also,
health outcomes are improved with early diagnosis.

 CF IS A LIFE-LONG DISEASE AND COPING CHANGES OVER TIME. People tend to

offer help right after diagnosis. Coping with CF is like riding a life-long roller coaster. The
best help is long-term help.