Kawasaki syndrome is a diagnosis of exclusion.

Treatment for this diagnosis may include IVIG and high dose aspirin therapy to prevent which condition?

Choice A rationale

A fundus 3 finger-breadths below the umbilicus after voiding on the third postpartum day is a normal finding. Fundal height typically descends approximately one finger-breadth per day following delivery. This physiological process, known as involution, involves myometrial contraction and autolysis, leading to the uterus returning to its pre-pregnant size.

Choice B rationale

Mild uterine cramping that resolves with NSAIDs is a normal postpartum finding. This cramping, often called afterpains, is caused by intermittent myometrial contractions. These contractions are stimulated by endogenous oxytocin and are essential for compressing uterine blood vessels and preventing postpartum hemorrhage. NSAIDs inhibit prostaglandin synthesis, which is a key mediator of pain and uterine contractions.

Choice C rationale

A fundus 2 finger-breadths above the pubic symphysis after voiding on the third postpartum day would be an extremely low finding and is not indicative of subinvolution. This position suggests that the uterus has already undergone a significant amount of involution, which is not the pathology of subinvolution. The fundus should still be palpable abdominally at this stage.

Choice D rationale

Uterine subinvolution is a condition where the uterus fails to return to its pre-pregnant state at the expected rate. A fundus palpated at the umbilicus on the third postpartum day is abnormal. The fundus should have descended approximately three finger-breadths below the umbilicus by this time. This assessment finding indicates a delay in the phys

Choice A rationale

Ignoring temper tantrums can sometimes be effective, but it may also escalate the behavior if the child feels their needs are not being met. From a psychological standpoint, the child is testing boundaries and seeking attention, and ignoring the behavior can be perceived as a lack of engagement, potentially intensifying the tantrum in an attempt to gain a reaction. This approach doesn't address the underlying developmental need for control and independence.

Choice B rationale

Distraction is a highly effective developmental strategy for toddlers. Toddlers have a short attention span and are easily redirected. By introducing a new, engaging activity, the nurse can shift the child's focus away from the source of frustration that triggered the tantrum. This technique prevents the tantrum from escalating and teaches the child to move on from a distressing situation without a power struggle, which is an important step in emotional regulation.

Choice C rationale

A toddler's cognitive development is not yet at a level where they can fully comprehend complex explanations about social norms or acceptable behavior. Their reasoning skills are still very primitive. Attempting to reason with a toddler during a tantrum is often futile and can even prolong the tantrum by giving the child attention for the negative behavior, thereby reinforcing it.

Choice D rationale

Placing a child in their room, or "time-out," is a discipline technique more appropriate for older children who can understand cause and effect. For a toddler, it can be perceived as abandonment or punishment without a clear connection to their behavior. This approach may not be effective and can cause fear or anxiety, failing to teach the child how to manage their emotions constructively.