HESI RN Case Study Answers: Cystic Fibrosis

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Week 4 HESI RN CASE STUDY CYSTIC FIBROSIS

1. Physiological Integrity/Clinical Manifestations

The nurse suspects that Darla may have cystic fibrosis (CF).

Which statement by the mother supports the diagnosis of CF?

A. "My daughter went to bed feeling fine last night and woke up with a high fever and a sore throat."

This may indicate epiglottitis.

B. "Lately Darla's eyes appear to have a yellow discoloration."

This may indicate some type of liver disorder.

"When I kiss my daughter, her skin tastes like salt."	Correct
Salty-tasting skin is a symptom of CF. It is caused by a high chloride and sodium concentration produced by the sweat glands.

D. "I can hear her heart beating when I lay my head on her chest."

Although this can indicate a heart defect, it may be normal in some children.

3. The healthcare provider (HCP) reviews Darla's medical chart.

A history of frequent respiratory infections.	Correct
The respiratory system is affected by abnormally thick, sticky secretions that cause airway obstruction to the lungs. Other clinical manifestations of CF include poor growth and/or weight loss, a dry and non-productive cough, and increased bleeding tendencies caused by a deficiency of the fat-soluble vitamin K.

Which documentation further supports the diagnosis of CF? (Select all that apply.) A.

B. An elevated white blood cell count (WBC).

The WBC count is not affected by CF.

C. Reports of episodic abdominal pain and crying.

These are not signs or symptoms of CF.

D. A sweat chloride level of 35 mEq/L.

A sweat chloride level below 40 mEq/L is a normal finding.

E. Reports of foul-smelling stools that have white streaks and are

sticky.	Correct
The term for undigested fat in the stools of clients with CF is steatorrhea. The foul smell is a result of the presence of protein. Large, loose and sticky are also terms that characterize the stools of a client with CF.

2. Safe and Effective Care/Diagnostic Test

The HCP prescribes a sweat test to confirm Darla's diagnosis of CF.

What information will the nurse include when teaching about the sweat test?

A. Informed consent will be needed for this invasive, diagnostic test.

Written consent is not needed, and the sweat test is not an invasive test.

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