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6 Kawasaki Disease Nursing Care Plans

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By Paul Martin, BSN, R.N.
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

6. Anxiety

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Anxiety

Nursing Diagnosis

May be related to

  • Acute, serious illness of unknown origin with possible cardiac sequelae.

Possibly evidenced by

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  • Verbalization of anxiety, use quotes.

Desired Outcomes

  • Client will experience decreased anxiety.
Nursing InterventionsRationale
Assess anxiety level of parents by asking them to rate their anxiety on a scale from 1 to 5 with 1 being no interventions.Assessment provides baseline information for the design of anxiety.
Educate the parents about information on the disease condition, signs and symptoms, diagnostics, and management.Promotes understanding; Explaining the unknown cause of the disease helps alleviate any guilt feelings of the parents regarding the acquisition of the disease.
Inform the parents of gentle
handling of the child as needed.		Provides information parents need to give comfort and avoid unnecessary touching to their child.
Encourage parents to express their feelings freely. Reassure parents that some anxiety is appropriate when their child is ill.Encouragement and reassurance help the parents to identify and regain control of their emotions.
Explain to parents that the child may
experience recurrent fever at home and
teach them how to take the child’s
temperature and when to notify
physician (temp. greater than 38.4°
C/101° F).		Ensure the child will obtain efficient care at home. Empowers the parent and reduces anxiety associated with uncertainty.
Explain to the parents that irritability is a symptom of Kawasaki disease and that they should avoid feelings of guilt; Encourage them to take some rest while the nurse cares for the child.Provides support and relief to parents in times of a stressful event.
Monitor child’s vital signs closely during IV immunoglobulin administration. Terminate the infusion and report immediately for untoward reactions such as fever, chills, urticaria, chest tightness, dyspnea, nausea/vomiting).Gamma globulin is a blood product and requires the same close observation for safe administration to prevent a reaction; this reassures parents that their child is receiving appropriate care.
Demonstrate ASA administration to
parents and instruct them to report any signs of toxicity (tinnitus, headache, dizziness, confusion). Explain that ASA may cause easy bruising and that the ASA
should be discontinued and the physician
notified if child exposed to chickenpox or influenza (risk of Reye’s syndrome).		Helps ensure safe, proper administration of ASA at home. Empowers parents.
Assist parents to make any referral and follow-up appointments for child.Assistance helps decrease anxiety.

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6. Anxiety

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:

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Paul Martin, BSN, R.N.
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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