KWSKI DS Flashcards

(31 cards)

1
Q

Mucocutaneous Lymph Node Syndrome

A

KAWASAKI DISEASE

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2
Q

It is a form of systemic vasculitis identified as an acute febrile illness with multiple systems affected in which the most common cause of acquired heart disease in children.

A

KAWASAKI DISEASE

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2
Q

Also known as Infantile Periarterisis Nodosa.

A

KAWASAKI DISEASE

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3
Q

A rare childhood illness that affects the blood vessels. Causing inflammation in the walls of medium-sized arteries all over the body.

A

KAWASAKI DISEASE

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4
Q

Commonly affects 80% of infants and young children. AT WHAT AGE?

A

<5 YRS AND BELOW

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5
Q

Etiology OF KAWASAKI DISEASE

A

UNKNOWN/IDIOPATHIC

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6
Q

Without treatment: dilation of coronary arteries resulting in
_____________________ or __________,

A

ECSTASIA (DILATION) or ANEURYSM FORMATION

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7
Q

What are the risk factors of Kawasaki Disease?

A

-AGE (<5YRS OLD)
-SEX (MORE LIKELY TO BOYS)
-ETHNICITY (ASIAN)

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8
Q

What are the symptoms of Kawasaki Disease?

A
  • PINK EYE
  • ORAL MUCOSAL CHANGE
  • ENLARGED LYMPH NODES
  • PATCHY RASH
  • PEELING SKIN
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9
Q

PATHOPHYSIOLOGY OF KD:

progressive inflammation of small vessels

A

ACUTE PHASE

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9
Q

PATHOPHYSIOLOGY OF KD:

Vasculitis progresses to medium-sized muscular
arteries, potentially damaging vessel walls

A

CORONARY ANEURYSMS

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10
Q

What are the Cardiac complications of KD?

A
  • CORONARY THROMBOSIS
  • MYOCARDIAL INFARCTION
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11
Q

CLINICAL MANIFESTATIONS OF KD:

WHAT PHASE?
- conjunctival hyperemia
- pharyngitis
- swollen hands and feet
- truncal rash
- enlarged lymph nodes
- diarrhea
- hepatic dysfunction

A

ACUTE PHASE

-fever

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12
Q

CLINICAL MANIFESTATIONS OF KD:

WHAT PHASE?
- cracked lips
- finger and toe desquamation
- joint pain
- cardiac disease
- thrombocytosis
- giant aneurysms - thrombus formation

A

SUBACUTE PHASE

-fever resolves

ACUTE MYCOCARDIAL INFARCTION:
- inconsolable crying
- restlessness
- pallor
- vomiting
- abdominal pain
- shock

CHEST PAIN (older children)

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13
Q

CLINICAL MANIFESTATIONS OF KD:

WHAT PHASE?

  • Day 40-70
  • Client appears to be well, all clinical signs of the
    disease have resolved, but laboratory values
    remain abnormal with signs of inflammation.
  • Transverse grooves of fingers and toenails (Beau’s
    line) for 1-2 mons.
  • Continuous skin peeling and nail shed can count.
    until 6-8wks.
  • Giant aneurysms → Thrombus formation
  • Acute myocardial infarction: inconsolable crying,
    restlessness, pallor, vomiting, abdominal pain,
    shock.
A

CONVALESCENT PHASE

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14
Q

What are the LABORATORY AND DIAGNOSTIC FINDINGS OF KD?

A
  • CRITERIA
  • CBC
  • ESR (Erythrocyte Sedimentation Rate)
  • URINALYSIS
  • LIVER ENZYME
  • ECHOCARDIOGRAM
15
Q

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

What are the CRITERIA FOR KD?

A
  • FEVER
  • BILATERAL CONJUCTIVAL CONGESTION WITHOUT EXUDATE
  • CHANGES IN UPPER RESPIRATORY MUCOUS MEMBRANES (Erythema or “strawberry tongue”) dryness, cracked and fissured lips
  • changes in extremities
  • polymorphous truncal rash
  • cervical adenopathy
16
Q

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his CBC result is?

A
  • Decrease hemoglobin and RBC.
  • Increased platelet count (by 2nd-4th wk
17
Q

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his Erythrocyte Sedimentation Rate result is?

A
  • Elevated
  • CRP
  • Alpha1 antitrypsin
18
Q

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his Urinalysis result is?

A

(+) protein and leukocytes

19
Q

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his Liver enzyme result is?

A
  • Moderately elevated
20
Q

LABORATORY AND DIAGNOSTIC FINDINGS OF KD:

A patient has KD if his ECHOCARDIOGRAM result is?

A
  • Cardiac catheterization is advised
  • Angiocardiography (visualization) /
    Angioplasty (Repair)
21
Q

NURSING MANAGEMENT OF KD:

  1. Monitor CARDIAC STATUS
A

a. daily weight, I&O
b. fluids
c. assess vital signs of HEART FAILURE
d. evaluate cardiac monitor

22
Q

NURSING MANAGEMENT OF KD:

  1. Administer medications
A

a. ASA or Ibuprofen
b. Intravenous Immunoglobulin (IVIG)
c. Abciximab (ReoPro)
d. Steroids : CONTRAINDICATED

23
NURSING MANAGEMENT OF KD: 3. Provide symptomatic relief
a. Minimize skin discomfort b. Mouth Care c. Monitor temperature d. Passive ROM e. Rest and quiet environment
24
NURSING INTERVENTION of KD
● Monitor pain- response to analgesia ● Cardiac monitoring and assessment- VS, signs of myocarditis (tachycardia, gallop rhythm) and monitor heart failure. ● Monitor I&O- hydration status: check skin turgor, weight, urine output, specific gravity. Pediatrics: hydration can be seen in the presence of the tears. ● Plan periods of rest and activities – encourage uninterrupted rest, move about freely with supervision, quiet and safe play, encourage use of fingers and toes. ● Provide oral care- give ice chips and ice packs, give gelatin if not contraindicated, do not use bristle toothbrush.
25
small and medium vessel vasculitis
KAWASAKI DISEASE
26
MNEMONIC: Warm CREAM
-FEVER (> 5DAYS) -CONJUNCTIVITIS (bilateral, non purulent) -RASH (erythematous, maculopapular, or morbilliform) -ERYTHEMA PALMS AND SOLES (with swelling) -ADENOPATHY, CERVICAL (1 unilateral node) -MUCOUS MEMBRANE (dry, red, strawberry tongue)
27
TREATMENT OF KD:
-HIGH DOSE ASA -IVIG
28
Complications of KD:
-CORONARY ARTERY ANEURYSMS -MYOCARDITIS so do an ECHOCARDIOGRAM
29