A child is admitted to the pediatric unit with a diagnosis of Kawasaki disease. Which nursing intervention is most appropriate during this initial phase?
Administering antibiotics
Monitoring for signs of coronary artery aneurysms
Providing comfort measures for peeling skin on the hand
Administering intravenous immunoglobulin (IVIG)
The Correct Answer is D
A. Administering antibiotics is not appropriate as Kawasaki disease is not caused by a bacterial infection; it is an inflammatory condition.
B. While monitoring for signs of coronary artery aneurysms is essential, the immediate intervention needed in the initial phase is to administer IVIG to mitigate inflammation and prevent complications.
C. Providing comfort measures for peeling skin is supportive but does not address the critical treatment needs in Kawasaki disease.
D. Administering intravenous immunoglobulin (IVIG) is the priority nursing intervention as it helps reduce inflammation and the risk of developing cardiovascular complications associated with Kawasaki disease.
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Correct Answer is A
Explanation
A. A child with varicella (chickenpox) should return to school only after all the blisters have crusted over, indicating that the infectious stage has passed and they are no longer contagious.
B. Receiving the varicella vaccine does not apply to children who already have the infection; vaccination is preventive, not a treatment for those already infected.
C. Completing one week of antiviral medication is not a sufficient criterion for returning to school, as the child may still be contagious until all lesions are crusted.
D. Returning to school as soon as the rash appears is not safe, as the child is highly contagious during the initial rash stage and until all lesions have crusted.
Correct Answer is B
Explanation
A. Administering IV fluids may be necessary but is not the first priority in managing a suspected airway emergency.
B. Placing the child on droplet precautions is the first action to take to prevent the spread of infection and protect healthcare workers, given the suspected diagnosis of epiglottitis.
C. Initiating IV antibiotics is essential but should follow ensuring that appropriate precautions and assessments are in place.
D. While obtaining an x-ray can confirm the diagnosis, the child's safety and airway management must be prioritized first to avoid potential respiratory distress.