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.
Here are six nursing care plans (NCP) and nursing diagnosis for Kawasaki Disease:
- Hyperthermia
- Acute Pain
- Impaired Skin Integrity
- Impaired Physical Mobility
- Impaired Oral Mucous Membrane
- Anxiety
Anxiety
Nursing Diagnosis
May be related to
- Acute, serious illness of unknown origin with possible cardiac sequelae.
Possibly evidenced by
- Verbalization of anxiety, use quotes.
Desired Outcomes
- Client will experience decreased anxiety.
Nursing Interventions | Rationale |
---|---|
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. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023Â (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Brain Tumor | 3 Care Plans
- Bronchiolitis | 5 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans