Which are the most serious complications for a child diagnosed with Kawasaki Disease?
Coronary thrombosis.
Coronary stenosis.
Decreased sedimentation rate.
Coronary artery aneurysm.
Hypocoagulability.
Correct Answer : A,D
Choice A rationale
Coronary thrombosis is a life-threatening complication where a blood clot forms in a coronary artery, leading to a myocardial infarction. Kawasaki disease causes inflammation of the blood vessels (vasculitis), which can damage the endothelium of the coronary arteries. This damage creates a site for clot formation, which can occlude blood flow and cause severe myocardial ischemia or death.
Choice B rationale
Coronary stenosis is a narrowing of the coronary arteries. While it can be a long-term complication of Kawasaki disease, leading to restricted blood flow, it is generally considered a less immediate and life-threatening complication than an acute thrombosis or aneurysm. The stenosis itself is not the most serious acute event, although it does increase the risk of later cardiac events.
Choice C rationale
A decreased sedimentation rate, or ESR, would not be a complication. In fact, an elevated ESR is a hallmark of the acute inflammatory process in Kawasaki disease. The ESR measures the rate at which red blood cells settle, which is increased during inflammation due to the presence of acute-phase proteins. A decreased ESR would indicate a reduction in inflammation, not a complication.
Choice D rationale
Coronary artery aneurysm is a primary serious complication of Kawasaki disease. The vasculitis can weaken the arterial walls, leading to the formation of aneurysms. These aneurysms can rupture, causing a hemorrhage, or they can be the site of a thrombosis. Aneurysms are a significant source of long-term morbidity and mortality in children with the disease.
Choice E rationale
Hypocoagulability, or a reduced ability to form blood clots, is not a complication of Kawasaki disease. In the acute phase, patients are more likely to be in a hypercoagulable state due to the systemic inflammatory response. This increased risk of clotting is what makes coronary thrombosis a significant concern, not hypocoagulability
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A localized area of breast tenderness is a potential sign of mastitis, which, while requiring attention, is not an immediate life-threatening condition. The client can be seen after more acute priorities, as mastitis typically develops over days.
Choice B rationale
A pain score of 3/10 in a 4-hour post-op client is an expected finding and can be addressed after more critical clients. This level of pain is not indicative of an acute, unstable physiological state that requires immediate intervention.
Choice C rationale
Moderate, dark red lochia is a normal finding 4 hours postpartum. The lochia is a mixture of blood, tissue, and mucus, and its color and amount are expected to change over time without indicating an immediate danger to the client.
Choice D rationale
Uterine tenderness, foul-smelling lochia, and a new temperature of 102 degrees F are classic signs of postpartum endometritis, a serious uterine infection. This presents a high risk for sepsis and septic shock, making it the highest priority for immediate assessment and intervention. .
Correct Answer is A
Explanation
Choice A rationale
Ambulation is the most effective intervention for preventing thromboembolism. Movement of the lower extremities promotes venous return and blood flow, preventing venous stasis, which is the primary predisposing factor for clot formation. Encouraging the client to get out of bed and walk as soon as medically stable after a cesarean birth reduces the risk of deep vein thrombosis and subsequent pulmonary embolism by a significant margin.
Choice B rationale
Instructing the client to press inward on their abdomen periodically is not an intervention for thromboembolism prevention. This action may cause discomfort and does not promote blood flow in the lower extremities. It is not a scientifically supported method for preventing venous stasis or clot formation in the legs, which are the main concerns for thromboembolism in this population.
Choice C rationale
Urging the client to cough and take deep breaths is an intervention to prevent respiratory complications like atelectasis and pneumonia. While important for post-operative care, this action does not directly address the risk of thromboembolism in the lower extremities. The mechanism of clot formation is related to venous stasis, which is best addressed by movement and not by respiratory exercises.
Choice D rationale
Urging the client not to dislodge the IV fluid line is an important general safety measure to ensure proper hydration and medication administration. However, it is not an intervention specifically aimed at preventing thromboembolism. The risk of thromboembolism is a circulatory issue related to venous stasis, and this action does not impact blood flow or clot formation in the veins. .
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