Health Promotion and Maintenance
17. A toddler with Kawasaki disease is being evaluated by a primary care clinic nurse 1 week following discharge. The nurse understands that it is a priority to instruct the parents to contact the clinic immediately if the child:
. Throws frequent temper tantrums.
. Is exposed to someone with chickenpox.
. Experiences night terrors.
. Develops a low-grade fever.
Test-Taking Tip
The word "immediately" in the stem of the question implies urgency, so you should look for a concern that must be addressed urgently. The behavioral issues listed would not require such attention (even if they were abnormal for the age group) and can be readily eliminated.
Content Area: Child Health, Infectious Disease; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Complications from Surgical Procedures and Health Alterations
Health Promotion and Maintenance
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Answer 1 is incorrect because temper tantrums are normal in this age group, and children with Kawasaki disease may experience the symptom of irritability for some time after treatment. Answer 2 is correct because children with Kawasaki disease are placed on aspirin therapy, so exposure to chickenpox puts the child at risk for Reye syndrome. Answer 3 is incorrect because night terrors can occur in toddlers and are a normal part of development. Answer 4 is incorrect because a low-grade fever can be related to minor infections, unlike the high, unremitting fever present in Kawasaki disease.