An adult patient presents to the emergency department with complaints of shortness of breath and increased work of breathing.

Assessment

The patient is alert and oriented times 3, skin is pink, warm and dry. BP 148/88, T98, P92. R 24, pulse oximetry 91% on room air. Assessment of the lung reveals expiratory wheezing throughout the lung fields.

The physician orders an albuterol nebulizer. What assessments should the nurse plan to complete after administering the albuterol?

(Select All that Apply.)

A) Increase dosing with a large meal:
Increasing the dosing with a large meal may not be appropriate as it could lead to overdosing and potential side effects. The dosage of pancrelipase should be determined by the healthcare provider based on the individual's needs and response to treatment.

B) Take the medication at least 2 hours prior to meals:
Taking the medication prior to meals may not be effective as the enzymes will not be available when food is consumed, which defeats the purpose of enzyme replacement therapy. The enzymes need to be present simultaneously with the food to aid in digestion.

C) Take the medication with meals.
Pancrelipase, such as Cotazym, is a pancreatic enzyme replacement therapy used to aid in the digestion of fats, proteins, and carbohydrates in individuals with pancreatic insufficiency. Taking the medication with meals is crucial because it helps to ensure that the enzymes are available to aid in the digestion of food. Without proper enzyme supplementation during meals, individuals with pancreatic insufficiency may experience malabsorption, leading to nutritional deficiencies and gastrointestinal symptoms.

D) Decrease fluid intake:
Decreasing fluid intake is not appropriate as it could lead to dehydration and may not have any significant impact on the efficacy of pancrelipase. In fact, adequate fluid intake is important for digestion and overall health.

A) Treatment with PPIs to decrease stomach acid:
Proton-pump inhibitors (PPIs) are used to decrease stomach acid production and are commonly prescribed for conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. However, they do not address the underlying cause of pancreatic insufficiency, which is the deficiency of pancreatic enzymes.

B) Treatment with stimulant laxatives:
Stimulant laxatives are used to stimulate bowel movements and are not indicated for the treatment of pancreatic insufficiency. Pancreatic insufficiency primarily affects the digestion of nutrients rather than bowel motility.

C) Replacement therapy with pancreatic enzymes.
Pancreatic insufficiency occurs when the pancreas does not produce enough digestive enzymes to properly digest food, leading to malabsorption of nutrients. Replacement therapy with pancreatic enzymes is the mainstay of treatment for pancreatic insufficiency. These enzymes, often prescribed in the form of pancreatic enzyme replacement therapy (PERT), help to supplement the deficient enzymes and aid in the digestion of fats, proteins, and carbohydrates.

D) Decrease food intake:
Decreasing food intake is not an appropriate treatment for pancreatic insufficiency. In fact, individuals with pancreatic insufficiency may need to increase their food intake to compensate for malabsorption and ensure adequate nutrition. Restricting food intake would worsen nutritional deficiencies and symptoms associated with malabsorption.