When caring for the child with Kawasaki disease, what should the ...

[LaDunn]

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care?
 
  a. Aspirin is contraindicated.
  b. The principal area of involvement is the joints.
  c. The child's fever is usually responsive to antibiotics within 48 hours.
  d. Therapeutic management includes administration of gamma globulin and salicylates.

Question 2

What action by the school nurse is important in the prevention of rheumatic fever (RF)?
 
  a. Encourage routine cholesterol screenings.
  b. Conduct routine blood pressure screenings.
  c. Refer children with sore throats for throat cultures.
  d. Recommend salicylates instead of acetaminophen for minor discomforts.

[jgranad15]

Answer to Question 1

ANS: D
High-dose intravenous gamma globulin and salicylate therapy are indicated to reduce the incidence of coronary artery abnormalities when given within the first 10 days of the illness. Aspirin is part of the therapy. Mucous membranes, conjunctiva, changes in the extremities, and cardiac involvement are seen. The fever of Kawasaki disease is unresponsive to antibiotics. It is responsive to anti-inflammatory doses of aspirin and antipyretics.

Answer to Question 2

ANS: C
Nurses have a role in prevention, primarily in screening school-age children for sore throats caused by group A streptococci. They can actively participate in throat culture screening or refer children with possible streptococcal sore throats for testing. Routine cholesterol screenings and blood pressure screenings do not facilitate the recognition and treatment of group A hemolytic streptococci. Salicylates should be avoided routinely because of the risk of Reye syndrome after viral illnesses.