A nurse is providing discharge teaching to the parents of a school-age child following the placement of a ventriculoperitoneal shunt. The nurse should determine that the teaching was effective when the parents identify which of the following as an indicator that the shunt has been displaced?

Choice A reason: A gluten-free diet is essential for managing celiac disease, as gluten can trigger harmful immune responses in affected individuals. This diet excludes all forms of wheat, barley, rye, and oats unless they are labeled gluten-free.

Choice B reason: A high-fiber diet is generally healthy but is not specifically related to the management of celiac disease. During exacerbations, it is more important to ensure that all foods are gluten-free to avoid triggering symptoms.

Choice C reason: There is no need for a low-protein diet in celiac disease management. Protein is not related to the immune response triggered by gluten.

Choice D reason: Wheat flour contains gluten and must be avoided in a gluten-free diet. Alternative flours such as rice, corn, or gluten-free blends should be used instead.

Choice A reason: Hyperpyrexia, or extremely high fever, is a common symptom of acetylsalicylic acid (aspirin) poisoning. The body's response to the toxic levels of aspirin can lead to an elevated temperature as part of a systemic inflammatory response.

Choice B reason: Jaundice is not a typical symptom of acute acetylsalicylic acid poisoning. It is more commonly associated with liver conditions that cause an increase in bilirubin levels.

Choice C reason: Neck vein distention is not a common finding in acetylsalicylic acid poisoning. It is often seen in conditions that cause increased pressure in the venous system, such as heart failure.

Choice D reason: Polyuria, or excessive urination, is not a direct symptom of acetylsalicylic acid poisoning. While changes in urination can occur due to renal involvement, hyperpyrexia is a more immediate concern.