1. The client/caregiver can define celiac disease and risk factors.
   1. It is a disease that makes the body not able to tolerate a protein called gluten.
   2. Gluten is found in wheat, rye, and barley. Gluten can also be found in the products we use, such as stamps, envelopes, some medicines, and some vitamins.
   3. This disease creates damage to the small intestines and interferes with absorption of nutrients from food when gluten is ingested or touched.
   4. It is considered a digestion disease and an autoimmune disorder.
   5. Celiac disease is a genetic disease.
   6. It can be triggered or activated for the first time after
      • Surgery
      • Pregnancy
      • Childbirth
      • Viral infection
      • Severe emotional stress
2. The client/caregiver can list symptoms of celiac disease.
   1. Celiac disease may exist without symptoms. There is still a risk for complications, such as malnutrition.
   2. It affects people differently. Symptoms may include one or more of the following:
      • Recurring gas, abdominal bloating, and pain
      • Chronic diarrhea
      • Pale, foul-smelling, or fatty stool
      • Weight loss or gain
      • Fatigue
      • Anemia
      • Bone or joint pain, osteoporosis
      • Behavioral changes (irritability is most common in children)
      • Tingling or numbness in legs
      • Muscle cramps
      • Seizures
      • Missed menstrual periods, infertility, and recurrent miscarriage
      • Delayed growth (failure to thrive in infants)
      • Mouth ulcers and tooth discoloration
      • Itchy skin rash
3. The client/caregiver can list measures to manage celiac disease.
   1. The only treatment for celiac disease is to follow a gluten-free diet. It is a lifetime requirement.
      1. Avoid wheat, rye, or barley products.
      2. Use corn, rice, soy, arrowroot, tapioca, or potato flours in recipes.
      3. Buy plain, frozen, or canned vegetables and season with herbs or spices.
      4. When eating out, select meat, poultry, or fish made without breading, gravies, or sauces.
      5. Store all gluten-free products in the refrigerator or freezer because they do not contain preservatives.
      6. Read labels carefully. Buy “gluten-free” products. Contact a food manufac- turer for product information if in doubt.
   2. Family members of a person with celiac disease may want to be tested.
   3. Seek others with celiac disease for information and support.
4. The client/caregiver can list possible complications.
   1. Malnutrition and anemia
   2. Lymphoma and adenocarcinoma
   3. Osteoporosis
   4. Miscarriage or congenital malformation
   5. Short stature
   6. Increased risk for other autoimmune diseases

Resources

Dietician
Support groups

Celiac Disease Foundation
www.celiac.org

National Foundation for Celiac Awareness
www.celiacawareness.org

American Dietetic Association
www.eatright.org

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com