A nurse is caring for an 18-month-old toddler in the emergency department who has Kawasaki disease. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?
Intravenous immunoglobulin (IVIG)
Aspirin
Penicillin
Acetaminophen
The Correct Answer is A
Choice A reason: Intravenous immunoglobulin (IVIG) is the main treatment for Kawasaki disease, as it reduces the inflammation of the blood vessels and the risk of coronary artery aneurysms. IVIG is given as a single infusion over 10 to 12 hours, within the first 10 days of the onset of fever.
Choice B reason: Aspirin is also used to treat Kawasaki disease, as it reduces the fever, pain, and inflammation. However, it is not the first-line treatment, and it is given after IVIG to prevent thrombosis and platelet aggregation. Aspirin is given at a high dose during the acute phase, and then at a low dose until the inflammation subsides.
Choice C reason: Penicillin is not indicated for Kawasaki disease, as it is an antibiotic that treats bacterial infections. Kawasaki disease is not caused by bacteria, but by an unknown trigger that activates the immune system and causes systemic vasculitis.
Choice D reason: Acetaminophen is not effective for Kawasaki disease, as it does not reduce the inflammation or the risk of complications. Acetaminophen may be used to treat mild pain or fever, but it is not the main treatment. Moreover, acetaminophen may mask the fever and delay the diagnosis of Kawasaki disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Tracheoesophageal fistula is a congenital anomaly that results from an abnormal connection between the trachea and the esophagus. It causes respiratory distress, choking, coughing, and cyanosis during feeding, and increased risk of aspiration pneumonia.
Choice B reason: Inguinal hernia is a protrusion of abdominal organs through the inguinal canal into the scrotum or labia. It causes a bulge in the groin area that may increase in size with crying or straining. It may also cause pain, vomiting, and impaired blood flow to the herniated tissue.
Choice C reason: Intussusception is a telescoping of one segment of the bowel into another, causing obstruction and impaired blood supply. It causes a palpable mass in the upper right quadrant, stools mixed with blood and mucus (resembling currant jelly), abdominal pain, vomiting, and shock.
Choice D reason: Hypertrophic pyloric stenosis is a narrowing of the pyloric sphincter due to hypertrophy of the surrounding muscle. It causes projectile vomiting, dehydration, weight loss, and a palpable olive-shaped mass in the upper right quadrant.
Correct Answer is C
Explanation
Choice A reason: Assessing the client's erythematous rash is an important action for the nurse to take, but it is not the priority. The rash is one of the minor criteria for diagnosing acute rheumatic fever, and it may not be present in all cases. The rash is usually non-pruritic and migratory, and it appears on the trunk and extremities.
Choice B reason: Identifying the degree of parental anxiety related to the diagnosis is an appropriate action for the nurse to take, but it is not the priority. The nurse should provide emotional support and education to the parents, and address their concerns and questions. However, this is not the most urgent action.
Choice C reason: Auscultating the rate and characteristics of the child's heart sounds is the priority action for the nurse to take, as it can detect the presence and severity of carditis, which is the most serious complication of acute rheumatic fever. Carditis is the inflammation of the heart muscle, valves, or pericardium, and it can cause murmurs, tachycardia, dysrhythmias, heart failure, or death.
Choice D reason: Using a pain-rating tool to determine the severity of the joint pain is an important action for the nurse to take, but it is not the priority. The joint pain is one of the major criteria for diagnosing acute rheumatic fever, and it is usually severe and migratory, affecting the large joints such as the knees, ankles, elbows, or wrists. The nurse should assess the pain level and provide analgesics and anti-inflammatory medications as prescribed.
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