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While caring for an 18 month old male with a diagnosis of kawasaki disease, which of the following would be an indication of deterioration?

A.

Cardiac arrhythmia

B.

Strep throat

C.

Hypotension

D.

bradycardia

Answer and Explanation

The Correct Answer is C

A. Cardiac arrhythmias can occur in Kawasaki disease, but they are not necessarily an indication of deterioration unless associated with significant clinical change.

B. Strep throat is unrelated to the progression of Kawasaki disease, though infection could complicate it.

C. Hypotension is a significant indicator of deterioration in Kawasaki disease, especially as it can signal cardiac involvement or shock.

D. Bradycardia is typically not a sign of deterioration in this condition, and it would need further evaluation.


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Related Questions

Correct Answer is ["A","D","E","F","H"]

Explanation

A. Dehydration: The infant is unable to stay latched to breast, indicating poor feeding. Combined with increased work of breathing and restlessness, there's a high risk of inadequate fluid intake, which can quickly lead to dehydration in infants.

B. Pulmonary edema: This is not typically associated with bronchiolitis or viral respiratory infections in infants unless there’s cardiac involvement or fluid overload, which is not indicated here.

C. Infection: While the infant likely already has a viral infection (e.g., RSV), the term “infection” in this context refers to the development of a secondary or worsening infection, which is not an immediate complication unless symptoms progress.

D. Apnea: Young infants, especially those under 3 months, are at risk of apneic episodes when experiencing respiratory infections like bronchiolitis, which this case suggests. Apnea is a known complication, especially in infants under 2–3 months.

E. Respiratory failure: The infant is showing head bobbing, intercostal retractions, RR of 65, and low oxygen saturation — all signs of increasing respiratory distress that, if uncorrected, may progress to respiratory failure.

F. Fatigue: Sustained increased respiratory effort (e.g., tachypnea, retractions, restlessness) can lead to exhaustion, especially in infants with limited energy reserves. Fatigue may worsen breathing and feeding issues.

G. Vomiting: Not reported or directly suggested by the scenario. While some infants may vomit with coughing, it’s not a primary anticipated complication in this case.

H. Hypoxia: With an oxygen saturation of 92% on room air, and clinical signs of distress, hypoxia is already present and must be corrected to prevent further complications.

Correct Answer is ["A","C","D"]

Explanation

A. Pulmonary atresia leads to little or no blood flow to the lungs, resulting in severe cyanosis if not surgically repaired.

B. PDA typically causes a left-to-right shunt and does not usually result in cyanosis unless other defects are present.

C. Transposition of the great arteries (TGA) creates parallel circulations, leading to severe cyanosis without mixing of blood.

D. Tetralogy of Fallot is a classic cyanotic heart defect, especially during "tet spells" due to right-to-left shunting.

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