6 Kawasaki Disease Nursing Care Plans

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Kawasaki Disease (mucocutaneous lymph node syndrome) is an acute systemic vasculitis of unknown origin that occurs usually in children less than 5 years of age. The disease is self-limiting, however, about 20% of those untreated will likely develop a cardiac complication such as coronary arteritis and aneurysm formation.

The disease is divided into 3 phases: the acute phase is described by progressive small blood vessels inflammation (vasculitis) accompanied by high fever, inflammation of the pharynx, dry, reddened eyes, swollen hands and feet, rash, and cervical lymphadenopathy. In the subacute phase, the manifestations disappear, but there is inflammation of larger vessels and the child is at highest risk of developing coronary aneurysms. In the convalescent phase (6-8 weeks after onset), signs and symptoms slowly go away, but laboratory values are not completely normal.

There are no specific tests to confirm Kawasaki disease, but normally the diagnosis is established on the basis of the child exhibiting at least 5 of 6 criterion manifestations. Treatment started within 10 days of symptoms often prevents the development of complications.

Nursing Care Plans

Nursing goals for a child with Kawasaki disease may include increased understanding of the parents and child about the disease condition, medical treatment and planned follow-up care, relief of pain, improved physical mobility, adequate coping, and absence of complications.

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Here are six nursing care plans (NCP) and nursing diagnosis for Kawasaki Disease:

  1. Hyperthermia
  2. Acute Pain
  3. Impaired Skin Integrity
  4. Impaired Physical Mobility
  5. Impaired Oral Mucous Membrane
  6. Anxiety
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Acute Pain

Nursing Diagnosis

May be related to

  • Inflammatory process (dry mucous membranes, conjunctivitis, pharyngitis, fever, joint pain, swollen hands and feet).

Possibly evidenced by

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  • Crying
  • Extreme irritability
  • Refusal to play
  • Cries when being touched or moved
  • Increased rating on pain scale

Desired Outcomes

  • Child will experience less pain.
Nursing InterventionsRationale
Assess pain level through observation (verbal expressions of pain, facial grimace), utilizing pain scale assessment, and by obtaining relevant pain information from parents about child’s expression of
pain.
Provides information upon which valid pain assessments and treatment effectiveness can be based.
Maintain the child’s room distraction-free and keep it dim.Darkness reduces eye discomfort caused by conjunctivitis.
Explain to parents reason for child’s
discomfort/irritability.
Promotes understanding and cooperation.
Explain to parents that irritability may persist for up to 2 months; that peeling skin on hands and feet is normal and not painful.Promotes understanding and allows parents to anticipate needs.
Explain to parents that joint pain may continue for several weeks; Teach parents on passive ROM exercises in a warm bath.Prolonged joint pain is not uncommon; ROM with heat helps increase flexibility.
Apply cool cloths to the skin, lotion, and soft, loose clothing on the child.Alleviate skin itching, therefore, promotes comfort.
Handle child gently and avoid unnecessary movements.Movement causes discomfort.
Apply lubricating lip ointments and
glycerin swabs to the oral mucosa;
offer cool liquids and soft foods.
Moistens dry oral mucosa to lessen discomfort and promote oral intake.
Administer IV immunoglobulin and high dose ASA therapy as indicated.Decreases inflammatory process and helps decrease fever.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for pediatric conditions and diseases:

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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