Safe, Effective Care Environment
40. A 4-year-old child is being discharged from a hospital following treatment for Kawasaki disease. Before the child is discharged, the parents should be taught to:
Safe, Effective Care Environment
40. A 4-year-old child is being discharged from a hospital following treatment for Kawasaki disease. Before the child is discharged, the parents should be taught to:
. Auscultate the heart.
. Administer antibiotics prior to dental work.
. Return to the clinic for repeat doses of immunoglobulin.
. Discuss the postponement of immunizations with the primary care practitioner.
Test-Taking Tip
The answer options should help you recall that immunoglobulin is a cornerstone of treatment for Kawasaki disease. Since this treatment modulates the immune system, select the answer option that addresses a potential effect of the treatment.
Content Area: Child Health, Infectious Disease; Integrated Process: Teaching and Learning; Cognitive Level: Application; Client Need/Subneed: Safe and Effective Care Environment/Safety and Infection Control/Standard/Transmission-based/Other Precautions
Safe, Effective Care Environment
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Answer 1 is incorrect because having the parents learn to auscultate the heart is not the best way to assist them in monitoring for cardiac complications. Rather, the parents should be taught to look for symptoms of impaired circulation, such as fatigue and pallor. Answer 2 is incorrect because it is not recommended that children with a history of Kawasaki disease receive prophylactic antibiotics prior to dental work. Kawasaki disease affects the coronary arteries, not the endocardium, so the risk of bacterial endocarditis is not increased. Answer 3 is incorrect because repeat doses of immunoglobulin are not indicated for this condition. Answer 4 is correct because a key component in the treatment of Kawasaki disease is the administration of intravenous immune globulin (IVIG). Parents should be advised that immunizations, such as the MMR (measles-mumps-rubella), may be delayed for some months since IVIG could render the vaccinations ineffective.