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 B
Explanation
A. Enforcing strict bed rest without any physical activity can lead to feelings of isolation and boredom, which may negatively affect the child's well-being and engagement.
B. Allowing the child to decorate their hospital room with personal items fosters a sense of ownership and comfort, helping to promote emotional well-being and engagement during hospitalization.
C. Limiting visits can increase feelings of loneliness and anxiety in the child, which is not conducive to their emotional health; maintaining social connections is important for well-being.
D. Using medical terms may confuse the child and does not support their understanding or engagement; explanations should be age-appropriate and easily understood.
Correct Answer is C
Explanation
A. Secondary prevention involves early detection and prompt intervention in health issues that have already occurred; providing education about stress does not fall under this category.
B. Suicide prevention is a specific aspect of mental health care and is not directly related to general stress education.
C. Primary prevention aims to prevent the onset of health issues and promote health and well-being, making the education on stress and its effects a form of primary prevention.
D. Tertiary prevention focuses on rehabilitation and management of existing diseases, which does not apply to teaching about stress effects.