Editing Pediatric Nursing – RN Practice Questions (section)

==Question 6==
A 2-year-old is diagnosed with Kawasaki disease and has received intravenous immunoglobulin. Which statements should the nurse include in discharge teaching? '''Select all that apply.'''
# "Your child will need follow-up echocardiograms to check the coronary arteries."
# "The measles-mumps-rubella and varicella vaccines should be delayed for about 11 months."
# "Peeling skin on the fingers and toes is expected and is not a sign of infection."
# "Stop the aspirin as soon as the fever resolves."
# "Call us if your child develops fever again after going home."
# "Extreme irritability during the illness is common and will gradually resolve."

'''Answer:''' 1, 2, 3, 5, and 6.

''Rationale:'' The feared complication of Kawasaki disease is coronary artery aneurysm, so serial echocardiography is standard. High-dose IVIG contains passive antibody that blunts the response to live vaccines, so MMR and varicella are deferred approximately 11 months. Periungual desquamation occurs in the subacute phase and is expected. Recurrent fever may signal IVIG resistance or ongoing inflammation and must be reported. Marked irritability is characteristic. Option 4 is incorrect: aspirin is continued, at an antiplatelet dose, after the anti-inflammatory phase, and is stopped only on the cardiologist's direction based on coronary findings. Kawasaki disease is one of the few pediatric indications for aspirin.