Maternity Nursing Q 58

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Which of the following would the nurse expect to assess in a child with celiac disease having a celiac crisis secondary to an upper respiratory infection?

  

     A. Respiratory distress

     B. Lethargy

     C. Watery diarrhea

     D. Weight gain

    

    

Correct Answer: C. Watery diarrhea

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Episodes of celiac crises are precipitated by infections, ingestion of gluten, prolonged fasting, or exposure to anticholinergic drugs. Celiac crisis is typically characterized by severe watery diarrhea. Celiac crisis is a rare initial presentation of CD characterized by severe diarrhea, dehydration, weight loss, hypoproteinemia, and metabolic and electrolyte disturbances. Although rare, it should be considered in patients with apparently unexplained chronic diarrhea.

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Option A: Respiratory distress is unlikely in a routine upper respiratory infection. Mainly present in children, celiac crisis causes profuse intractable diarrhea with severe metabolic disturbances (such as acidosis and hypokalemia), hypotension, neuromuscular weakness, cardiac arrhythmias, and respiratory failure.

Option B: Irritability, rather than lethargy, is more likely. Due to the wide variety of symptoms that may present themselves, it can sometimes be difficult to diagnose celiac disease. One person might have diarrhea and abdominal pain, while another person has irritability or depression.

Option D: Because of the fluid loss associated with severe watery diarrhea, the child’s weight is more likely to be decreased.

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