A nurse is planning care for a preschool-age child who is in the acute phase of Kawasaki disease. Which of the following interventions should the nurse include in the plan of care?

Monitor the child's cardiac status.

Give scheduled doses of acetaminophen every 6 hr.

Provide stimulation with children of the same age in the play room.

Administer antibiotics via intermittent IV bolus for 24 hr.

Answer and Explanation

The Correct Answer is A

A.   Kawasaki disease involves inflammation of the blood vessels and can lead to serious cardiac complications, including coronary artery aneurysms. Monitoring cardiac status is essential to detect and manage these risks.
B.   While managing fever is a part of treating Kawasaki disease, acetaminophen is typically used as needed rather than on a strict schedule unless fever is persistent.
C.   During the acute phase of Kawasaki disease, children often feel very irritable and unwell; large group activities may be overwhelming and inappropriate.
D.   Kawasaki disease is not caused by a bacterial infection, and antibiotics are not part of the treatment. Instead, treatment usually involves high-dose aspirin and intravenous immunoglobulin.

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Correct Answer is D

Explanation

A: Changing the TPN bag and tubing every 24 hours is standard practice to prevent infection, so this action is appropriate.
B: Checking glucose levels every 6 hours is necessary because TPN can significantly affect blood glucose levels.
C: Gradually increasing the TPN rate is a standard procedure to monitor tolerance to the infusion.
D: This indicates a need for intervention. TPN lines should not be used for any other infusions to prevent contamination and interactions between the nutrition formula and medications.

A. "Plan to take this medication with food." B. "Limit foods that contain vitamin D while taking this medication. C. "Limit foods that contain folic acid while taking this medication. D. "Plan to take this medication with antacids.

Correct Answer is A

Explanation

A. Phenytoin should be taken with food to minimize gastrointestinal side effects and enhance absorption.
B. There is no specific requirement to limit foods containing vitamin D while taking phenytoin.

C. Phenytoin does not typically interfere with folic acid metabolism, so there is no need to limit foods containing folic acid.
D. Phenytoin should not be taken with antacids, as they can decrease its absorption.

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A nurse is planning care for a preschool-age child who is in the acute phase of Kawasaki disease. Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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