Nursing Assessment, Management and Treatment of Autoimmune Diseases
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Assessment A complete physical and mental health assessment is conducted. Symptoms re- lated to the disease are an integral part of the patient assessment. However, signs and symptoms of celiac disease can vary significantly, and signs and symptoms may differ in children and adults (Mayo Clinic, 2020a). Upon assessment, nurses should monitor for the presence of the following symp- toms in adults (Mayo Clinic, 2020a):
● Nausea and vomiting. ● Pale, foul-smelling stools.
| NURSING CONSIDERATION
In children, celiac disease leads to an inability to absorb adequate amounts of nutrients. This may lead to failure to thrive in infants, weight loss, anemia, delayed puberty, short stature, and tooth enamel damage (Mayo Clinic, 2020a). Nurses must be aware of the potential for these types of complica- tions when working with children who have celiac disease. Long-term health effects People with celiac disease have a 2X greater risk of developing coronary ar- tery disease (CAD) and a 4X greater risk of developing small bowel malignancies. Untreated celiac disease can lead to oth- er autoimmune disorders such as Type 1 diabetes and multiple sclerosis (MS) as well as dermatitis herpetiformis, anemia, osteoporosis, infertility, miscarriage, and neurologic conditions such as epilepsy and migraines (Celiac Disease Founda- tion, 2021). Diagnosis and treatment Diagnosis In addition to the presence of relevant signs and symptoms, results from some diagnostic tests help to confirm the diag - nosis. These include the following (Mayo Clinic, 2020a; Meadows-Oliver, 2019): ● Histologic changes observed on small-bowel biopsy specimens, which confirms diagnosis. ● Poor glucose absorption as evidenced by a glucose tolerance test. ● Decreases in albumin, calcium, sodium, potassium, cholesterol, and phospholipids.
● Abdominal pain. ● Bloating and gas. ● Constipation. ● Diarrhea. ● Fatigue. ● Nausea and vomiting. ● Weight loss.
Accor ding to the Mayo Clinic (2020a), more than 50% of adults with celiac dis- ease have signs and symptoms that are unrelated to the digestive system. These types of signs and symptoms include the following: ● Anemia. ● Dermatitis herpetiformis. ● Fatigue. ● Headaches. ● Hyposplenism. ● Joint pain. ● Mouth ulcers. ● Symptoms related to the nervous system such as numbness and tingling of the extremities, impaired cognition, and problems with balance. ● Osteoporosis. Children with celiac disease are more likely than adults to experience digestive problems such as the following (Mayo Clinic, 2020a): ● Abdominal distention. ● Chronic diarrhea. ● Flatulence.
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