A nurse is preparing to administer digoxin to a 6-month-old infant. Prior to administering the dose, the nurse measures the apical heart rate. The nurse should withhold the dose if the infant's apical heart rate is less than what rate?

A. Cracked lips:
Incorrect: While red, cracked lips are part of the mucous membrane changes seen in Kawasaki disease, they are not specific to the acute stage. Mucous membrane changes can occur in both the acute and subacute stages.
B. Desquamation of the skin:
Incorrect: Desquamation, or peeling of the skin, is more characteristic of the subacute or convalescent stages of Kawasaki disease, particularly on the fingers and toes.
C. Normal appearance:
Incorrect: In the acute stage, the child with Kawasaki disease typically exhibits signs of illness, including fever and other clinical manifestations. A "normal appearance" would not be expected in the acute stage.
D. Conjunctival hyperemia.
Explanation: Conjunctival hyperemia, or redness of the eyes, is a common clinical manifestation of the acute stage of Kawasaki disease. Other typical signs and symptoms during this stage include fever, mucous membrane changes (such as red, cracked lips), changes in the extremities, rash, and cervical lymphadenopathy.

A. Symptoms are continuous throughout the day:
Incorrect: Continuous symptoms throughout the day are more indicative of moderate or severe persistent asthma, not mild persistent asthma.
B. Daytime symptoms occur more than twice a week:
Correct Answer: Children with mild persistent asthma may experience symptoms more than twice a week, but less than once a day.
C. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value:In mild persistent asthma, pulmonary function tests (e.g., PEF or FEV1) remain normal or close to normal, with values typically ≥80% of the predicted value, reflecting good lung function between episodes.
D. Nighttime symptoms occur approximately twice a month:
Mild persistent asthma often involves nighttime symptoms or awakenings occurring 3–4 times per month. If nighttime symptoms occur more frequently (e.g., once weekly), it suggests moderate persistent asthma.
E. Minor limitations occur with normal activity:Children with mild persistent asthma may experience minor limitations in their normal activities. These limitations are not severe and do not significantly impact daily life.