A child with secondary enuresis who reports of dysuria or urgency should be evaluated for what condition? (Select all that apply.)

The correct answer is choice A: Administer pancreatic enzymes between meals if at all possible.

Choice A rationale:

Administer pancreatic enzymes between meals if at all possible. This is the correct choice. When educating the parents and child with cystic fibrosis about the administration of pancreatic enzymes, it's important to emphasize that these enzymes should be given between meals whenever feasible. Administering them between meals, when the stomach is less acidic and less likely to release the enzymes prematurely, ensures optimal digestion of food and absorption of nutrients. This approach aligns with the physiological need to supplement pancreatic enzyme function due to the inadequate natural enzyme production in cystic fibrosis.

Choice B rationale:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal. This choice is a valid option for administering pancreatic enzymes. While it's true that the enzymes can be taken either by swallowing the capsules whole or by opening them and sprinkling the contents on a small amount of food at the start of a meal, this method can vary based on individual preferences and abilities. However, the primary focus should be on timing (between meals) to achieve the best enzymatic action.

Choice C rationale:

Do not administer pancreatic enzymes if the child is receiving antibiotics. This statement is not accurate. There is no general contraindication to administering pancreatic enzymes while a child is on antibiotics. However, it's important for the healthcare provider to be aware of all the medications the child is taking to ensure there are no potential drug interactions or effects on absorption. Always consult with the healthcare team before adjusting the administration of any medication.

Choice D rationale:

Decrease the dose of pancreatic enzymes if the child is having frequent, bulky stools. This statement is not consistent with typical practice. If a child is experiencing frequent, bulky stools, it may actually indicate that the pancreatic enzyme dosage needs adjustment (increasing the dose rather than decreasing). Bulky stools can suggest poor digestion and absorption, which might require more enzymes to properly break down nutrients. Dosage adjustments should always be made under the guidance of the healthcare provider based on factors such as stool consistency, weight gain, and nutritional status.

The correct answer is choice C.

Choice C rationale:

Placing the avulsed tooth in cold milk is the most suitable medium for transporting it to the dentist. Cold milk helps preserve the viability of the tooth's cells and tissues, which is crucial for successful reimplantation. The temperature and composition of cold milk provide a suitable environment to prevent cell damage.

Choice A rationale:

Placing the tooth in a dry, clean jar is not recommended. A dry environment can cause the tooth's cells to dry out and become nonviable, making reimplantation less successful.

Choice B rationale:

Warm salt water is not the optimal choice for transporting an avulsed tooth. Warm water can cause damage to the tooth's cells, and salt water may not provide the necessary conditions to maintain the tooth's viability.

Choice D rationale:

Placing the tooth in cold water might seem logical, but it is not as effective as cold milk. Cold water lacks the protective properties and nutrients that milk provides, potentially leading to a higher risk of cell damage in the avulsed tooth.