A nurse is assisting with food selection for a client who follows kosher dietary traditions.

Which of the following food choices should the nurse include on the client’s food tray?

The correct answer is B.

Choice A reason: Completing oral hygiene is important for overall health, especially for individuals with cystic fibrosis, as they are at a higher risk for dental problems due to thick mucus that can harbor bacteria. However, oral hygiene does not have a direct impact on the effectiveness of postural drainage. Postural drainage is a technique used to clear mucus from the lungs, and while maintaining oral hygiene is beneficial, it is not a prerequisite for this procedure.

Choice B reason: Using a bronchodilator, such as an ibuterol inhaler, is recommended before postural drainage because it helps to open the airways, making the procedure more effective. Bronchodilators work by relaxing the muscles around the airways, which can become constricted in conditions like cystic fibrosis. This relaxation allows for easier clearance of mucus during postural drainage.

Choice C reason: Pancrelipase is an enzyme supplement used to aid digestion in patients with cystic fibrosis, who often have pancreatic insufficiency. While taking pancrelipase is crucial for nutrient absorption, it is not specifically related to the respiratory treatment of postural drainage. Therefore, it is not necessary to take pancrelipase immediately before this procedure.

Choice D reason: Eating a meal before postural drainage is not recommended. The procedure involves placing the body in positions that facilitate the drainage of mucus from the lungs due to gravity. Having a full stomach can cause discomfort, increase the risk of vomiting, and may hinder the effectiveness of the drainage. It is best to perform postural drainage when the stomach is empty, either before meals or at least 1.5 hours after eating.

The correct answer is choice B. Increase exercise.

Exercise can help stimulate bowel movements and prevent constipation, which is a common side effect of opioid medications.

Exercise can also improve blood circulation, reduce stress, and enhance mood, which can benefit clients who have chronic pain.

Choice A is wrong because decreasing insoluble fiber intake can worsen constipation.

Insoluble fiber adds bulk to the stool and helps it pass more easily through the colon.

Clients who take opioid medications should increase their intake of insoluble fiber from sources such as whole grains, fruits, vegetables, nuts, and seeds.

Choice C is wrong because drinking less water can lead to dehydration and hardening of the stool, which can make it more difficult to pass.

Clients who take opioid medications should drink plenty of water to keep the stool soft and moist.

Choice D is wrong because taking a laxative every day can cause dependence, tolerance, and electrolyte imbalance.

Laxatives should be used only as a last resort and under the guidance of a health care provider.

Clients who take opioid medications should try other methods of preventing constipation first, such as increasing exercise, fiber, and water intake.