When caring for the child with Kawasaki disease, the nurse should understand what principle of care?
The child's fever is usually responsive to antibiotics within 48 hours.
Aspirin is contraindicated.
Therapeutic management includes administration of gamma globulin and aspirin.
The principal area of involvement is the joints.
The Correct Answer is C
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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C: Administering penicillin.
Choice A rationale:
Imposing strict bed rest for 4 to 6 weeks. This choice is not the most appropriate therapeutic management for rheumatic fever. While rest is important during the acute phase, strict bed rest for 4 to 6 weeks is excessive and could lead to physical deconditioning and psychological distress for the child.
Choice B rationale:
Administering corticosteroids if chorea develops. This choice is relevant to the management of rheumatic fever but is not the primary treatment. Chorea is a movement disorder that can occur as a complication of rheumatic fever. Corticosteroids may be used to manage chorea symptoms, but they are not the mainstay of treatment for rheumatic fever itself.
Choice C rationale:
Administering penicillin. This is the correct choice. Penicillin is the mainstay of treatment for rheumatic fever. It helps eradicate the group A streptococcal infection that triggers the inflammatory response leading to rheumatic fever. Penicillin is essential to prevent further complications such as rheumatic heart disease.
Choice D rationale:
Avoiding salicylates (aspirin). This choice is also relevant to the management of rheumatic fever. Salicylates, including aspirin, are used to relieve symptoms and reduce inflammation. However, in children with acute rheumatic fever, salicylates are contraindicated due to the risk of developing Reye's syndrome, a serious condition that affects the brain and liver.
Correct Answer is B
Explanation
The correct answer is choice B. Epinephrine.
Choice A rationale:
Diphenhydramine. Diphenhydramine is an antihistamine commonly used to relieve allergic symptoms such as itching, rash, and runny nose. While it can be part of the treatment for anaphylactic reactions, it is not the medication of choice for immediate administration in the case of a severe anaphylactic reaction like the one described in the scenario.
Choice B rationale:
Epinephrine. Correct Answer. In cases of severe anaphylactic reactions, epinephrine (adrenaline) is the medication of choice for immediate administration. Epinephrine acts rapidly to reverse life-threatening symptoms, such as airway constriction, low blood pressure, and hives. It works by dilating airways, increasing heart rate, and improving blood pressure.
Choice C rationale:
Dopamine. Dopamine is a medication used to increase blood pressure and cardiac output in certain critical situations. However, it is not the first-line treatment for anaphylactic reactions. Epinephrine's effects on airway and cardiovascular function make it the preferred choice in this context.
Choice D rationale:
Calcium chloride. Calcium chloride is not the appropriate medication for treating anaphylactic reactions. Its main medical uses include treating hypocalcemia (low blood calcium levels) and certain cardiac arrhythmias. It does not address the primary symptoms and physiological changes associated with anaphylaxis.
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