Page 1072 - Saunders Comprehensive Review For NCLEX-RN

prescribed; these medications should not be
administered before the diagnosis is confirmed,
because the medications mask the polyarthritis.
7. Initiate seizure precautions if the child is experiencing
chorea.
8. Instruct the parents about the importance of follow-up
and the need for antibiotic prophylaxis for dental
work, infection, and invasive procedures.
9. Advise the child to inform the parents if anyone in
school develops a streptococcal throat infection.
XI. Kawasaki Disease
A. Description
1. Kawasaki disease, also known as mucocutaneous lymph
node syndrome, is an acute systemic inflammatory
illness.
2. The cause is unknown, but may be associated with an
infection from an organism or toxin.

3. Cardiac involvement is the most serious

complication; aneurysms can develop.

B. Assessment

1. Acute stage
a. Fever
b. Conjunctival hyperemia
c. Red throat
d. Swollen hands, rash, and enlargement
of cervical lymph nodes
2. Subacute stage
a. Cracking lips and fissures
b. Desquamation of the skin on the tips of
the fingers and toes
c. Joint pain
d. Cardiac manifestations
e. Thrombocytosis
3. Convalescent stage: Child appears normal, but signs of
inflammation may be present.
C. Interventions
1. Monitor temperature frequently.
2. Assess heart sounds and heart rate and rhythm.
3. Assess extremities for edema, redness, and
desquamation.
4. Examine eyes for conjunctivitis.
5. Monitor mucous membranes for inflammation.
6. Monitor strict intake and output.
7. Administer soft foods and liquids that are neither too
hot nor too cold.

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