Nutrition and Cystic Fibrosis

1
Nutrition and Cystic Fibrosis
2
Nutrition and Cystic FibrosisAn Educational
Flip Chart for People with CF and their
FamiliesThe 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.
3

(No Transcript)
4
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-blockingmedication may be used to help
the enzymes work better.)
5

(No Transcript)
6
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?
7
Dont let those calories get away by not taking
yourenzymes!
8
So DONT let those calories (and vitamins,
minerals, proteins) get away by not taking your
enzymes!
9
Good Nutrition Means
Energy
Growing
Healthier Lungs
Fighting Infections
10
..because good nutrition means energy,
growing and developing, fighting infections,
and healthier lungs!
11
Which foods are good for you?Which foods do you
take enzymes with?
12

• 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 arent 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 dont 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 its nice to be able to give a
  starving 6-year-old a fruity snack in the car,
  or for an adolescent to have a coke with friends
  without enzymes.)

13
Nutrition and Cystic Fibrosis

• Special thanks to Solvay Pharmaceuticals for
  making this project possible with an unrestricted
  educational grant.

• Judy Marciel, RN, MSN, CNS, CPNP
• Vanderbilt Childrens Hospital
• Cystic Fibrosis Care Center
• 2003

14
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 Childrens Hospital
Cystic Fibrosis Care CenterNashville,
TennesseePhone (615) 343-76172003 (All
clip art images are from Microsoft Design
Gallery http//dgl.microsoft.com/?cag1)