KWSKI DS

Question 1

Mucocutaneous Lymph Node Syndrome

Answer 1

KAWASAKI DISEASE

Question 2

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.

Answer 2

KAWASAKI DISEASE

Question 2

Also known as Infantile Periarterisis Nodosa.

Answer 2

KAWASAKI DISEASE

Question 3

A rare childhood illness that affects the blood vessels. Causing inflammation in the walls of medium-sized arteries all over the body.

Answer 3

KAWASAKI DISEASE

Question 4

Commonly affects 80% of infants and young children. AT WHAT AGE?

Answer 4

<5 YRS AND BELOW

Question 5

Etiology OF KAWASAKI DISEASE

Answer 5

UNKNOWN/IDIOPATHIC

Question 6

Without treatment: dilation of coronary arteries resulting in
_____________________ or __________,

Answer 6

ECSTASIA (DILATION) or ANEURYSM FORMATION

Question 7

What are the risk factors of Kawasaki Disease?

Answer 7

-AGE (<5YRS OLD)
-SEX (MORE LIKELY TO BOYS)
-ETHNICITY (ASIAN)

Question 8

What are the symptoms of Kawasaki Disease?

Answer 8

• PINK EYE
• ORAL MUCOSAL CHANGE
• ENLARGED LYMPH NODES
• PATCHY RASH
• PEELING SKIN

Question 9

PATHOPHYSIOLOGY OF KD:

progressive inflammation of small vessels

Answer 9

ACUTE PHASE

Question 9

PATHOPHYSIOLOGY OF KD:

Vasculitis progresses to medium-sized muscular
arteries, potentially damaging vessel walls

Answer 9

CORONARY ANEURYSMS

Question 10

What are the Cardiac complications of KD?

Answer 10

• CORONARY THROMBOSIS
• MYOCARDIAL INFARCTION

Question 11

CLINICAL MANIFESTATIONS OF KD:

WHAT PHASE?
- conjunctival hyperemia
- pharyngitis
- swollen hands and feet
- truncal rash
- enlarged lymph nodes
- diarrhea
- hepatic dysfunction

Answer 11

ACUTE PHASE

-fever

Question 12

CLINICAL MANIFESTATIONS OF KD:

WHAT PHASE?
- cracked lips
- finger and toe desquamation
- joint pain
- cardiac disease
- thrombocytosis
- giant aneurysms - thrombus formation

Answer 12

SUBACUTE PHASE

-fever resolves

ACUTE MYCOCARDIAL INFARCTION:
- inconsolable crying
- restlessness
- pallor
- vomiting
- abdominal pain
- shock

CHEST PAIN (older children)

Question 13

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.

Answer 13

CONVALESCENT PHASE

Question 14

What are the LABORATORY AND DIAGNOSTIC FINDINGS OF KD?

Answer 14

• CRITERIA
• CBC
• ESR (Erythrocyte Sedimentation Rate)
• URINALYSIS
• LIVER ENZYME
• ECHOCARDIOGRAM

Question 15

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

What are the CRITERIA FOR KD?

Answer 15

• 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

Question 16

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his CBC result is?

Answer 16

• Decrease hemoglobin and RBC.
• Increased platelet count (by 2nd-4th wk

Question 17

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his Erythrocyte Sedimentation Rate result is?

Answer 17

• Elevated
• CRP
• Alpha1 antitrypsin

Question 18

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his Urinalysis result is?

Answer 18

(+) protein and leukocytes

Question 19

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his Liver enzyme result is?

Answer 19

• Moderately elevated

Question 20

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his ECHOCARDIOGRAM result is?

Answer 20

• Cardiac catheterization is advised
• Angiocardiography (visualization) /
  Angioplasty (Repair)

Question 21

NURSING MANAGEMENT OF KD:

1. Monitor CARDIAC STATUS

Answer 21

a. daily weight, I&O
b. fluids
c. assess vital signs of HEART FAILURE
d. evaluate cardiac monitor

Question 22

NURSING MANAGEMENT OF KD:

2. Administer medications

Answer 22

a. ASA or Ibuprofen
b. Intravenous Immunoglobulin (IVIG)
c. Abciximab (ReoPro)
d. Steroids : CONTRAINDICATED

Question 23

NURSING MANAGEMENT OF KD:
3. Provide symptomatic relief

Answer 23

a. Minimize skin discomfort
b. Mouth Care
c. Monitor temperature
d. Passive ROM
e. Rest and quiet environment

Question 24

NURSING INTERVENTION of KD

Answer 24

● 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.

Question 25

small and medium vessel vasculitis

Answer 25

KAWASAKI DISEASE

Question 26

MNEMONIC:

Warm CREAM

Answer 26

-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)

Question 27

TREATMENT OF KD:

Answer 27

-HIGH DOSE ASA
-IVIG

Question 28

Complications of KD:

Answer 28

-CORONARY ARTERY ANEURYSMS
-MYOCARDITIS

so do an ECHOCARDIOGRAM