Pediatric Nursing Demystified

Monitor abdomen for distention, presence of bowel sounds.

Monitor intake and output.

Monitor bowel function.

Explain the disorder and treatment to the family.

Celiac Disease

What Went Wrong?

Celiac disease occurs when enzymes in the intestinal mucosal cells are damaged

when they are in contact with gluten,resulting in decreased absorption by the

small intestines. Gluten is a protein found in wheat, rye, oats, and barley. Celiac

disease is detected in infants when they are introduced to gluten-containing foods.

Signs and Symptoms

Diarrhea

Fatty, foul-smelling stool

Distention

Vomiting

Irritability

Abdominal pain

Nursing alertThe child may be malnourished and experience coagulation prob-

lems due to the malabsorption of fat-soluble vitamins.

Test Results

Glucose tolerance test: Poor absorption of glucose

Serum: Decreased level of albumin, potassium, cholesterol, calcium,

and sodium

Blood count: Decreased platelets, white blood cells (WBC), and hematocrit

Stool: High fat content

Biopsy: Positive for celiac disease

Treatment

Diet free from wheat, rye, oats, and barley.

Increase dietary protein, calories.

Decrease dietary fat.

Administer water-soluble vitamins A and D.

Administer iron supplements.

Administer folic acid.

Nursing Intervention

Teach the family about the disorder and treatment and inform them that

dietary changes are for the child’s entire life.

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