The recommended children's dosage of Keflex is 25 to 50 mg/kg/day in divided doses. The maximum daily safe dosage for a child weighing 42 lb is: Round to the nearest tenth.

(Number Only, do not enter mg, kg, or day with your answer)

The correct answer is choice C. Therapeutic management includes administration of gamma globulin and aspirin.

Choice A rationale:

The child's fever in Kawasaki disease is not usually responsive to antibiotics within 48 hours. Kawasaki disease is an inflammatory condition of blood vessels, and it doesn't typically respond to antibiotics. The fever associated with Kawasaki disease often persists even with appropriate treatment, and the management focuses on reducing inflammation and preventing complications.

Choice B rationale:

Aspirin is not contraindicated in Kawasaki disease. In fact, aspirin is a key component of the therapeutic management of Kawasaki disease. It is used to reduce inflammation and prevent the development of coronary artery aneurysms, a severe complication of the disease. However, the dosing of aspirin in Kawasaki disease is different from its use for pain relief, and it should be administered under medical supervision.

Choice C rationale:

Therapeutic management of Kawasaki disease does include administration of gamma globulin and aspirin. Gamma globulin is given to reduce the risk of coronary artery involvement and aneurysm formation. Aspirin, at a specific dose regimen, is used to decrease inflammation and platelet aggregation, thus preventing clot formation in the coronary arteries.

Choice D rationale:

The principal area of involvement in Kawasaki disease is not the joints. Kawasaki disease primarily affects the blood vessels, particularly the coronary arteries. The inflammation of these arteries can lead to the development of coronary artery aneurysms, which is a critical concern in Kawasaki disease. Joint involvement is not a prominent feature of this condition.

The correct answers are choices A, B, and D.

Choice A rationale:

Decreased urinary output can be a sign of heart failure, especially in infants. In heart failure, the heart's ability to pump effectively can lead to decreased blood flow to the kidneys, resulting in decreased urine production.

Choice B rationale:

Sweating (inappropriate) is a symptom of heart failure in infants. Infants with heart failure might sweat excessively, especially while feeding or crying, due to the effort required by the heart to pump blood effectively.

Choice C rationale:

Warm flushed extremities are not typically associated with heart failure in infants. In heart failure, extremities might actually become cool and pale due to poor circulation.

Choice D rationale:

Anorexia, or a lack of appetite, is a common sign in infants with heart failure. The increased effort required for feeding due to compromised cardiac function can lead to poor feeding and decreased appetite.

Choice E rationale:

Weight loss can occur in infants with heart failure due to inadequate caloric intake, difficulty with feeding, and increased metabolic demands associated with heart failure. However, it's not as specific a sign as decreased urinary output, sweating, and anorexia.