The nurse is caring for a child diagnosed with Kawasaki disease. Keeping the pathophysiology in mind, the nurse carefully monitors the child for which complication?

Potential Condition: Viral Pneumonia

High fever (39.88°C/103.8°F), severe fatigue, chills, productive cough, and dyspnea suggest a respiratory infection. Bilateral lung consolidation on x-ray is consistent with viral pneumonia. Negative bacterial culture supports a viral rather than bacterial etiology. Elevated WBC count (12,300/mm³) is slightly above normal, which can occur with viral infections. Crackles in upper lobes, diminished breath sounds in lower lobes are common findings in pneumonia.

Actions to Take (Correct Choices)

Cluster client care to allow for rest: Viral pneumonia leads to fatigue and respiratory distress. Minimizing exertion conserves energy and improves recovery.

Administer prescribed antipyretic: Reduces fever, improves comfort, and helps decrease metabolic demand on the body.

Incorrect Actions and Rationale:

Replace pancreatic enzymes – This is necessary for cystic fibrosis, not viral pneumonia.

Maintain airborne precautions – Airborne precautions are required for tuberculosis (TB), not viral pneumonia. Pneumonia typically requires droplet precautions only if caused by a pathogen like influenza.

Obtain a peak respiratory flow rate – More relevant for asthma, not pneumonia.

Parameters to Monitor (Correct Choices)

Level of fatigue: Fatigue indicates worsening illness or improvement. Increasing exhaustion may suggest hypoxia or worsening pneumonia.

Oxygen saturation levels: 92% on room air is borderline low, requiring monitoring for worsening hypoxemia. Oxygen therapy may be needed if saturation drops further.

Incorrect Parameters:

Allergen triggers – Relevant for asthma, not viral pneumonia.

Diet high in protein and calcium – Important for cystic fibrosis, but not a primary concern for pneumonia management.

Blood glucose levels – More relevant for diabetes or steroid therapy, not viral pneumonia.

A. Croup is a viral infection that typically presents with a barking cough and stridor, rather than difficulty swallowing and excessive drooling.

B. Epiglottitis is a life-threatening condition characterized by sudden onset of fever, drooling, difficulty swallowing, and difficulty speaking (dysphonia). It is a medical emergency and often caused by Haemophilus influenzae type B.

C. Bronchiolitis is usually caused by respiratory syncytial virus (RSV) and presents with wheezing, cough, and respiratory distress but not typically with drooling or difficulty swallowing.

D. Laryngotracheobronchitis (another name for croup) also presents with a barking cough and stridor but does not cause difficulty swallowing or drooling.