Page 973 - Saunders Comprehensive Review For NCLEX-RN

vitamin D deficiency. Instruct the parents about the importance of
providing these supplements.
VIII. Celiac Disease
A. Description
1. Celiac disease is also known as gluten enteropathy or
celiac sprue.
2. Intolerance to gluten, the protein component of

wheat, barley, rye, and oats, is characteristic.
3. Celiac disease results in the accumulation of the amino
acid glutamine, which is toxic to intestinal mucosal
cells.
4. Intestinal villous atrophy occurs, which affects
absorption of ingested nutrients.
5. Symptoms of the disorder occur most often between
the ages of 1 and 5 years.
6. There is usually an interval of 3 to 6 months between
the introduction of gluten in the diet and the onset of
symptoms.
7. Strict dietary avoidance of gluten minimizes the risk of
developing malignant lymphoma of the small
intestine and other gastrointestinal malignancies.
B. Assessment
1. Acute or insidious diarrhea
2. Steatorrhea
3. Anorexia
4. Abdominal pain and distention
5. Muscle wasting, particularly in the buttocks and
extremities
6. Vomiting
7. Anemia
8. Irritability

C. Celiac crisis

1. Precipitated by fasting, infection, or ingestion of
gluten
2. Causes profuse watery diarrhea and vomiting
3. Can lead to rapid dehydration, electrolyte imbalance,
and severe acidosis
D. Interventions

1. Maintain a gluten-free diet, substituting corn,

rice, and millet as grain sources.

2. Instruct the parents and child about lifelong

elimination of gluten sources such as wheat, rye, oats,
and barley.

973