A nurse is providing discharge teaching to the parents of a school-age child who has cystic fibrosis. Which of the following responses by the parents indicates an understanding of the teaching?

Cystic fibrosis is an inherited disorder that affects the exocrine glands, causing thick secretions in the lungs, pancreas, and gastrointestinal tract. Pancreatic enzyme deficiency commonly occurs because thick mucus blocks pancreatic ducts, preventing digestive enzymes from reaching the intestines. This leads to malabsorption of fats, proteins, and fat-soluble vitamins. Home management includes nutritional support, pancreatic enzyme replacement, adequate fluids, and increased salt intake. Rationale: A. Restricting sodium is incorrect because children with cystic fibrosis lose excessive sodium and chloride through sweat due to abnormal chloride channel function. They are at increased risk for dehydration and electrolyte imbalance, especially during hot weather or exercise. These children usually require increased salt intake rather than sodium restriction. B. Pancreatic insufficiency prevents proper digestion and absorption of nutrients, especially fats and proteins. Enzyme replacement must be given with all meals and snacks to improve digestion, promote weight gain, and reduce symptoms such as steatorrhea and malnutrition. This is a key part of long-term cystic fibrosis management. C. Preparing low-fat meals with limited protein is incorrect because children with cystic fibrosis require a high-calorie, high-protein, and often high-fat diet to support growth and compensate for malabsorption. Restricting fat and protein would worsen nutritional deficiencies and poor weight gain. Nutritional intake should be increased, not limited. D. Limiting daily fluid intake is incorrect because adequate hydration is essential to help thin respiratory secretions and reduce the risk of mucus plugging. Children with cystic fibrosis are also prone to fluid loss through excessive sweating. Increased fluid intake supports airway clearance and helps maintain proper hydration status.