Transcript Nutrition and Cystic Fibrosis

Nutrition
and
Cystic Fibrosis
Nutrition and Cystic Fibrosis:
An Educational Flip Chart for People with CF and their Families
The purpose of this educational flip chart is to provide a “hands-on” tool
(the lamination allows for touching the pictures with the ability to clean the flip
chart between use) to teach children, adolescents and adults, about the GI
pathophysiology of CF, how enzymes work and why they are so important to take
appropriately. The emphasis is on attaining good nutrition to stay healthy!
The flip chart can be used for initial education, developmental updates,
and when problems or educational needs are identified.
Each of the pages of the flip chart is accompanied by a sample script,
including salient teaching points. The script should be individualized,
incorporating developmental and age-appropriate modifications.
The flip chart and script pages are provided in Microsoft PowerPoint format,
but are meant to be printed. A flip chart can then easily be created by laminating
and binding the pages. Alternately, the pages may be placed in plastic page covers
and then in a binder. If the script page is placed behind the previous education
page, it allows the educator to view the script while the patient or family member
is viewing the education page.
Pointing out the middle illustration
“This is the stomach, and this is the small intestines (or gut). When you eat,
food goes into your stomach, then into your gut. Behind the stomach is the
pancreas. The pancreas makes digestive enzymes which turn foods into nutrition
that is absorbed into your blood and then taken to all parts of your body.”
Pointing out the top left illustration
“In normal digestion, there is a tube from the pancreas to the intestine called
the pancreatic duct. Enzymes come from the pancreas through the pancreatic
duct to the intestine every time food goes into the intestines.”
Pointing out the bottom right illustration
“When you have CF, the thick mucus in the pancreatic duct
blocks the enzymes from entering the intestines.”
(This drawing can also be used to illustrate the fact that bicarbonate-rich
pancreatic juices also enter the intestine from the pancreas, and sometimes
enough of the bicarbonate is blocked so that an “acid-blocking”
medication may be used to help the enzymes work better.)
“You have to put enzymes into your stomach whenever food goes into
your stomach. In the stomach, the food turns into smaller pieces,
and the capsule dissolves and the enzyme beads are released. In the
intestines, the powder in the beads is released, and the enzyme
powder digests the smaller parts of foods. Then the nutrition and
vitamins are absorbed and sent to all the other parts of your body.”
“So remember, every time food goes into your mouth, enzymes go into
your mouth! They need to end up in your stomach at the same time.
Enzymes only last for about 45 to 60 minutes. Food leaves your
stomach and you get hungry and have to eat again. Enzymes leave
your stomach, and you have to take enzymes again, too.”
“And remember to ONLY use the BRAND NAME enzymes that
have been prescribed for you by your CF doctor!”
“What kind of enzymes do you take?”
“What do your enzymes look like?”
Don’t let those calories get
away by not taking your
enzymes!
“So DON’T let those calories
(and vitamins, minerals, proteins…)
get away by not taking your
enzymes!”
Energy
Growing
Good Nutrition Means…
Healthier Lungs
Fighting Infections
“…..because good nutrition means …
energy,
growing and developing,
fighting infections,
and
healthier lungs!”
Which foods are good for you?
Which foods do you take enzymes with?
 “Tell (or show) me which of these foods are good for you?”
(The teaching point is that a very wide variety of foods are good
for people with CF. It is particularly important to emphasize
that high fat, high calorie foods that aren’t good for people
without CF, are always healthy for people with CF.)
 “Which foods should you take enzymes with?”
(A glass of milk, and a milk shake were specifically included, because
people with CF and their families often do not realize that they have to
take enzymes with certain “drinks” (they often don’t realize that certain
“drinks” are “foods”). The picture of an apple with a book (maybe
snacking on an apple when reading or doing homework), and the bowl of
fruit, are meant to point out that certain foods that have no fat, can be
eaten without enzymes. Of course the norm should be eating high fat,
high calorie foods, but sometimes it’s nice to be able to give a starving 6year-old a “fruity snack” in the car, or for an adolescent to have a coke
with friends without enzymes.)
Special thanks to Solvay
Pharmaceuticals for making this
project possible with an
unrestricted educational grant.
Nutrition
and
Cystic Fibrosis
Judy Marciel, RN, MSN, CNS, CPNP
Vanderbilt Children’s Hospital
Cystic Fibrosis Care Center
2003
My hope is that this flip chart will be helpful to CF health care
professionals in teaching people with CF and their families about the
importance of good nutrition
ultimately resulting in better nutrition and better outcomes.
I would like to express my sincere thanks to Solvay Pharmaceuticals
for making this project possible with an unrestricted educational grant.
I am also very grateful to Barbara Blankstein, for her tireless and
good-humored assistance in creating this flip chart in Microsoft
PowerPoint® format.
Judy Marciel, RN, MSN, CNS, CPNP
Vanderbilt Children’s Hospital
Cystic Fibrosis Care Center
Nashville, Tennessee
Phone: (615) 343-7617
2003
(All clip art images are from Microsoft® Design Gallery http://dgl.microsoft.com/?cag=1)