A nurse is reinforcing teaching for a client who has a new ascending colostomy. Which of the following comments by the client indicates an understanding of the teaching?

Silence can be a natural part of the group therapy process, and individuals may need additional time to process their thoughts and feelings before contributing. By allowing the client extra time, the nurse creates a non-threatening space for the client to participate when they are ready.

In some group settings, certain members might dominate the conversation, making it challenging for others to contribute. By requesting that other group members be mindful of their speaking time, the nurse helps create space for the silent client to share their thoughts and experiences.

The nurse can privately communicate with the silent client outside the group session to offer support and explore any concerns or barriers they may be experiencing. This individualized attention can help the client feel valued and encourage their participation in future sessions. Appointing the client to lead the discussion or telling them to leave the group if they cannot contribute are not appropriate actions. These approaches can increase the client's discomfort and create a negative atmosphere, which goes against the principles of group therapy. It is important to foster an inclusive and supportive environment that encourages participation at each person's pace.

Reduced fat in the stools

Pancrelipase is an enzyme replacement therapy used in the treatment of cystic fibrosis, a condition that affects the exocrine glands, including the pancreas. Cystic fibrosis impairs the production and secretion of digestive enzymes, leading to malabsorption of nutrients, particularly fats.

Pancrelipase contains enzymes (lipase, amylase, and protease) that help in the digestion of fats, carbohydrates, and proteins, respectively. By administering pancrelipase, the nurse aims to improve the digestion and absorption of nutrients, especially fats. As a result, one of the therapeutic effects of pancrelipase in a child with cystic fibrosis is a reduction in fat in the stools, as the enzymes help break down dietary fats properly, preventing their excretion undigested.

Improved respiratory function in (option B) is not correct because while cystic fibrosis primarily affects the respiratory system, the administration of pancrelipase does not directly improve respiratory function. Other treatments and interventions are used to manage respiratory symptoms in cystic fibrosis.

Improved absorption of vitamins B and C in (option C) is not correct because Pancrelipase primarily aids in the digestion and absorption of fats, carbohydrates, and proteins. Although the absorption of vitamins can be indirectly affected by improved digestion, the main therapeutic effect of pancrelipase is related to fat digestion.

Decreased sodium excretion in (option D) is not correct because Pancrelipase does not have a direct effect on sodium excretion. Sodium balance is primarily regulated by the kidneys, and interventions targeting sodium excretion would involve dietary changes or medications targeting renal function.