A child diagnosed with celiac disease is being educated on dietary restrictions.
Which food should the nurse instruct the child to avoid?

Choice A rationale

Allergic reactions to food items typically manifest with systemic symptoms like hives, angioedema, vomiting, or diarrhea, in addition to skin manifestations. While a rash can occur, the localized nature of the dry, scaly patches on the hands, specifically after using a new hand soap, makes a food allergy less likely as the primary cause.

Choice B rationale

Irritant contact dermatitis is a localized inflammatory reaction of the skin caused by direct contact with an irritating substance. New scented hand soaps often contain chemicals and fragrances that can disrupt the skin barrier, leading to erythema, dryness, and scaling, particularly on areas frequently exposed like the hands. The absence of vesicles or oozing supports an irritant rather than an allergic reaction.

Choice C rationale

Fungal infections of the skin, such as tinea manuum, typically present with scaling, redness, and sometimes vesicles or pustules. While a pet can be a source of fungal infections, the recent introduction of a new hand soap makes an irritant reaction a more probable cause than a fungal infection, which usually develops more gradually.

Choice D rationale

Atopic dermatitis (eczema) is a chronic inflammatory skin condition characterized by itchy, red, and scaly patches. While it can affect the hands, it often has a history of exacerbations and remissions and may be associated with other atopic conditions like asthma or allergies. The sudden onset after using a new product points more towards contact dermatitis rather than an eczema flare-up in a child with no significant medical history.

Choice A rationale

Currant jelly stools (stools mixed with blood and mucus) and drawing the knees to the chest are classic signs and symptoms of intussusception in infants. The telescoping of one part of the intestine into another leads to bowel obstruction, inflammation, and bleeding, resulting in the characteristic stool appearance and abdominal pain that causes the infant to draw their knees up in an attempt to relieve the discomfort.

Choice B rationale

Ribbon-like stools and visible peristalsis are more characteristic of Hirschsprung's disease (congenital aganglionic megacolon), a condition where a segment of the colon lacks nerve cells, impairing motility and leading to constipation and a narrowed segment of the bowel. Visible peristalsis can occur due to the bowel trying to push stool through the narrowed segment.

Choice C rationale

Explosive watery diarrhea and fever are typical signs of gastroenteritis, an inflammation of the gastrointestinal tract usually caused by a viral or bacterial infection. While vomiting can occur in both conditions, the stool characteristics and the presence of fever are more indicative of gastroenteritis rather than intussusception.

Choice D rationale

Bright red blood in the stool without other symptoms is less specific to intussusception. While blood can be present, it is usually mixed with mucus, giving the currant jelly appearance. Bright red blood alone might suggest other conditions like anal fissures or lower gastrointestinal bleeding. .