KWSKI DS Flashcards
Mucocutaneous Lymph Node Syndrome
KAWASAKI DISEASE
It is a form of systemic vasculitis identified as an acute febrile illness with multiple systems affected in which the most common cause of acquired heart disease in children.
KAWASAKI DISEASE
Also known as Infantile Periarterisis Nodosa.
KAWASAKI DISEASE
A rare childhood illness that affects the blood vessels. Causing inflammation in the walls of medium-sized arteries all over the body.
KAWASAKI DISEASE
Commonly affects 80% of infants and young children. AT WHAT AGE?
<5 YRS AND BELOW
Etiology OF KAWASAKI DISEASE
UNKNOWN/IDIOPATHIC
Without treatment: dilation of coronary arteries resulting in
_____________________ or __________,
ECSTASIA (DILATION) or ANEURYSM FORMATION
What are the risk factors of Kawasaki Disease?
-AGE (<5YRS OLD)
-SEX (MORE LIKELY TO BOYS)
-ETHNICITY (ASIAN)
What are the symptoms of Kawasaki Disease?
- PINK EYE
- ORAL MUCOSAL CHANGE
- ENLARGED LYMPH NODES
- PATCHY RASH
- PEELING SKIN
PATHOPHYSIOLOGY OF KD:
progressive inflammation of small vessels
ACUTE PHASE
PATHOPHYSIOLOGY OF KD:
Vasculitis progresses to medium-sized muscular
arteries, potentially damaging vessel walls
CORONARY ANEURYSMS
What are the Cardiac complications of KD?
- CORONARY THROMBOSIS
- MYOCARDIAL INFARCTION
CLINICAL MANIFESTATIONS OF KD:
WHAT PHASE?
- conjunctival hyperemia
- pharyngitis
- swollen hands and feet
- truncal rash
- enlarged lymph nodes
- diarrhea
- hepatic dysfunction
ACUTE PHASE
-fever
CLINICAL MANIFESTATIONS OF KD:
WHAT PHASE?
- cracked lips
- finger and toe desquamation
- joint pain
- cardiac disease
- thrombocytosis
- giant aneurysms - thrombus formation
SUBACUTE PHASE
-fever resolves
ACUTE MYCOCARDIAL INFARCTION:
- inconsolable crying
- restlessness
- pallor
- vomiting
- abdominal pain
- shock
CHEST PAIN (older children)
CLINICAL MANIFESTATIONS OF KD:
WHAT PHASE?
- Day 40-70
- Client appears to be well, all clinical signs of the
disease have resolved, but laboratory values
remain abnormal with signs of inflammation. - Transverse grooves of fingers and toenails (Beau’s
line) for 1-2 mons. - Continuous skin peeling and nail shed can count.
until 6-8wks. - Giant aneurysms → Thrombus formation
- Acute myocardial infarction: inconsolable crying,
restlessness, pallor, vomiting, abdominal pain,
shock.
CONVALESCENT PHASE
What are the LABORATORY AND DIAGNOSTIC FINDINGS OF KD?
- CRITERIA
- CBC
- ESR (Erythrocyte Sedimentation Rate)
- URINALYSIS
- LIVER ENZYME
- ECHOCARDIOGRAM
LABORATORY AND DIAGNOSTIC FINDINGS OF KD:
What are the CRITERIA FOR KD?
- FEVER
- BILATERAL CONJUCTIVAL CONGESTION WITHOUT EXUDATE
- CHANGES IN UPPER RESPIRATORY MUCOUS MEMBRANES (Erythema or “strawberry tongue”) dryness, cracked and fissured lips
- changes in extremities
- polymorphous truncal rash
- cervical adenopathy
LABORATORY AND DIAGNOSTIC FINDINGS OF KD:
A patient has KD if his CBC result is?
- Decrease hemoglobin and RBC.
- Increased platelet count (by 2nd-4th wk
LABORATORY AND DIAGNOSTIC FINDINGS OF KD:
A patient has KD if his Erythrocyte Sedimentation Rate result is?
- Elevated
- CRP
- Alpha1 antitrypsin
LABORATORY AND DIAGNOSTIC FINDINGS OF KD:
A patient has KD if his Urinalysis result is?
(+) protein and leukocytes
LABORATORY AND DIAGNOSTIC FINDINGS OF KD:
A patient has KD if his Liver enzyme result is?
- Moderately elevated
LABORATORY AND DIAGNOSTIC FINDINGS OF KD:
A patient has KD if his ECHOCARDIOGRAM result is?
- Cardiac catheterization is advised
- Angiocardiography (visualization) /
Angioplasty (Repair)
NURSING MANAGEMENT OF KD:
- Monitor CARDIAC STATUS
a. daily weight, I&O
b. fluids
c. assess vital signs of HEART FAILURE
d. evaluate cardiac monitor
NURSING MANAGEMENT OF KD:
- Administer medications
a. ASA or Ibuprofen
b. Intravenous Immunoglobulin (IVIG)
c. Abciximab (ReoPro)
d. Steroids : CONTRAINDICATED
NURSING MANAGEMENT OF KD:
3. Provide symptomatic relief
a. Minimize skin discomfort
b. Mouth Care
c. Monitor temperature
d. Passive ROM
e. Rest and quiet environment
NURSING INTERVENTION of KD
● Monitor pain- response to analgesia
● Cardiac monitoring and assessment- VS, signs of
myocarditis (tachycardia, gallop rhythm) and
monitor heart failure.
● Monitor I&O- hydration status: check skin turgor,
weight, urine output, specific gravity.
Pediatrics: hydration can be seen in the presence of
the tears.
● Plan periods of rest and activities – encourage
uninterrupted rest, move about freely with
supervision, quiet and safe play, encourage use of
fingers and toes.
● Provide oral care- give ice chips and ice packs, give
gelatin if not contraindicated, do not use bristle
toothbrush.
small and medium vessel vasculitis
KAWASAKI DISEASE
MNEMONIC:
Warm CREAM
-FEVER
(> 5DAYS)
-CONJUNCTIVITIS
(bilateral, non purulent)
-RASH
(erythematous, maculopapular, or morbilliform)
-ERYTHEMA PALMS AND SOLES
(with swelling)
-ADENOPATHY, CERVICAL
(1 unilateral node)
-MUCOUS MEMBRANE
(dry, red, strawberry tongue)
TREATMENT OF KD:
-HIGH DOSE ASA
-IVIG
Complications of KD:
-CORONARY ARTERY ANEURYSMS
-MYOCARDITIS
so do an ECHOCARDIOGRAM
