Steve is diagnosed with celiac disease and experiences celiac crisis secondary to upper respiratory tract infection; which of the following would Nurse Nancy expect to assess?
A. Lethargy
B. Weight gain
C. Respiratory distress
D. Watery diarrhea
Correct Answer: D. Watery diarrhea
Episodes of celiac crises are precipitated by infections, ingestion of gluten, prolonged fasting, or exposure to anticholinergics. Celiac crisis is typically characterized by severe watery diarrhea. Celiac crisis is a life-threatening syndrome in which patients with celiac disease have profuse diarrhea and severe metabolic disturbances.
Option A: Irritability, rather than lethargy, is more likely. Clinically it is characterized by severe diarrhea, dehydration, and metabolic disturbances including hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and hypoproteinemia.
Option B: Because of the fluid loss associated with severe watery diarrhea, the child’s weight is more likely to be decreased. In childhood, failure to thrive is an important aspect of history, while in adulthood the corresponding symptom would be unexplained weight loss.
Option C: Respiratory distress is unlikely in a routine upper respiratory tract infection. Symptoms from other than gastrointestinal systems include recurrent aphthous ulcers in the mouth, iron deficiency anemia, ataxia, chronic headaches, and delayed menarche.