When caring for the child with Kawasaki disease, the nurse should understand what principle of care?

The correct answer is choice C: Oral rehydration solution (ORS).

Choice A rationale:

Clear liquids, 1 to 2 ounces at a time, might not be sufficient to adequately rehydrate a child with severe dehydration. Clear liquids lack the necessary electrolytes and glucose content to effectively combat dehydration and replace lost fluids.

Choice B rationale:

Administration of antidiarrheal medication is not the initial step in managing severe dehydration caused by acute diarrhea and vomiting. Antidiarrheal medications can slow down the gastrointestinal motility, which may exacerbate the problem by delaying the elimination of the causative agent and prolonging the dehydration.

Choice C rationale:

Oral rehydration solution (ORS) is the recommended initial intervention for managing severe dehydration caused by acute diarrhea and vomiting. ORS contains the appropriate balance of electrolytes (sodium, potassium, chloride) and glucose to replace lost fluids and electrolytes, thereby helping to rehydrate the child effectively. It is absorbed even when digestion is impaired due to the illness.

Choice D rationale:

Intravenous fluids might be necessary if the child's condition is very severe and oral intake cannot be maintained. However, it's not the first-line intervention. Oral rehydration is preferred whenever feasible because it is less invasive and can be administered even in mild to moderate dehydration cases.

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.