When caring for a child with Kawasaki disease, the nurse should understand that principle of care?
A.
The child’s fever is usually responsive to antibiotics within 48 hours
B.
The principal area of involvement is the joints
C.
Aspirin is contraindicated
D.
Therapeutic management includes the administration of gamma globulin and aspirin.
The Correct Answer and Explanation is:
The correct answer is D. Therapeutic management includes the administration of gamma globulin and aspirin.
Explanation:
Kawasaki disease is an acute, self-limited vasculitis that primarily affects children. It is characterized by a prolonged fever, rash, conjunctivitis, changes in the lips and oral cavity, and lymphadenopathy. The condition can lead to significant cardiovascular complications, such as coronary artery aneurysms, if not managed appropriately.
Aspirin and gamma globulin (IVIG) are the cornerstone treatments for Kawasaki disease.
- Aspirin: Although aspirin is generally avoided in children due to the risk of Reye’s syndrome, it is a key component of Kawasaki disease management. High-dose aspirin is used initially to control inflammation and fever, followed by a lower dose for its antiplatelet effects, which helps prevent coronary artery thrombosis. This treatment regimen is critical in reducing the risk of coronary artery complications.
- Intravenous Immunoglobulin (IVIG): IVIG is administered to reduce inflammation and prevent coronary artery damage. It is typically given within the first ten days of illness to be most effective. IVIG works by modulating the immune response and has been shown to decrease the incidence of coronary artery abnormalities significantly.
Why the other options are incorrect:
- A. The child’s fever is usually responsive to antibiotics within 48 hours: This is incorrect because Kawasaki disease is not caused by bacterial infection; it is an inflammatory condition. Antibiotics are not effective in treating the fever associated with Kawasaki disease.
- B. The principal area of involvement is the joints: This is incorrect. While Kawasaki disease can cause joint pain, the principal area of involvement is the cardiovascular system, particularly the coronary arteries. Joint involvement is not a primary feature.
- C. Aspirin is contraindicated: This is incorrect. Aspirin is actually indicated and is an essential part of the treatment plan for Kawasaki disease, despite the general caution against its use in children due to the risk of Reye’s syndrome.
In summary, the management of Kawasaki disease involves a combination of aspirin and IVIG to address the inflammation and prevent serious complications, particularly those affecting the heart.