KAWASAKI DISEASE

a.k.a. Mucocutaneous Lymph node syndrome

Infantile polyarteritis

Definition: An acute febrile illness of young children that causes

widespread vasculitis.

Principal finding:
Vasculitis - inflammation of blood vessels
- can lead to formation of aneurysms, platelet
accumulation, formation of thrombi

Causes: - unknown
- possible genetic role after exposure to a virus, bacteria or
other pathogen

S/S: - fever for five (5) days or more, unresponsive to antipyretics

- lethargy
- irritability
- reddened, swollen hands and feet
- conjunctivitis
- “strawberry” tongue č red cracked lips
- rash in trunk area
- enlarged cervical lymph nodes
- reddened, swollen joints
- abdominal pain, anorexia, diarrhea

Assessment Findings: - fever for five (5) days or more, unresponsive to

antipyretics
- occurrence of s/s
- increase WBC
- increase platelet count
Therapeutic Management: - IV gamma globulin
- Aspirin
- Coronary Artery Bypass Surgery (CAD)

Nursing Interventions: - keep clothing from constructing or irritating rash

- moisten lips with lip balm to prevent from
cracking
- offer frequent fluids
- observe for signs of GI upset
- avoid pressure on extremities č edema
- monitor I and O
- give prescribed drugs

Health Teachings: - Aspirin therapy after hospitalization

- report exposure to viral illness
- possibility of long-term management
- need to delay immunization
- encourage to schedule a follow up exam in two
(2) to three (3) weeks
RHEUMATIC HEART DISEASE

Definition: Systemic inflammatory disease of childhood that occurs

two (2) to six (6) weeks following an inadequately
treated URTI č group A beta-hemolytic streptococci.

Most common symptom: Arthritis

S/S: (Revised Jones Criteria):

Major: Arthritis
Carditis
Erythema Marginatum
Subcutaneous Nodules
Chonea

Minor: previous Hx of Rheumatic Fever

Arthralgia
Increase levels of acute phase reactants
Prolonged PR interval on ECG
Fever

Other s/s: chest pain

SOB
Tachycardia
Bradycardia
Complain of sore throat
Cough

Dx Test: chest x-ray

Echocardiography
Cardiac catheterization
Assessment Findings: - recurrent streptococcal infection
- recent Hx of low-grade fever č unexplained
epistaxis
and abdominal pain
- occurrence of s/s
- increase WBC count
- anemia

Therapeutic Management: - antibiotics

- corticosteroids
- Phenobarbital
- heart valve replacement

Nursing Interventions: - give prescribed antibiotics on time

- stress importance of bed rest
- provide analgesics as needed
- allow patient to express feelings and
concerns

Health Teachings: - disorder, Dx, treatment

- scheduling frequent rest periods
- report early s/s of left sided heart failure
and recurrent strep. Infection
- avoid people č resp. infections
- compliance č prolonged antibiotic therapy
- prophylaxis before invasive procedures
ENDOCARDITIS

Definition: Inflammation and infection of the endocardium or valves

of the heart.

Causes: - complication of congenital heart diseases:

Tetralogy of fallot, VSD, coarotation of aorta

- streptococci infection, possible: staphylococcal or

fungal

S/S: - pale
- anorexia
- weight loss
- arthralgia
- malaise
- chills
- periods of sweating
- heart murmurs
- petechiae of conjunctiva/oral mucosa
- hemorrhages
- left upper quadrant pain from spleen infraction

Dx Tests: Echocardiogram
Blood Cultures
CBC
U/A

Assessment Findings: - occurrence of s/s

- increase WBC
- anemia
- proteinuria
- hematuria
- vegetative growths on heart valves based on ECG
Therapeutic Management: IV antibiotic therapy
Corrective surgery
Bed rest
Sufficient fluid intake

Nursing Intervention: - stress importance of bed rest

- allow patient to express his concerns
- obtain Hx of allergies
- administer antibiotics on time

Health Teaching: - disorder, Dx, treatment

- compliance of medication therapy
- watch for early s/s of reoccurrence of disease and
notify physician immediately
- prophylaxis before invasive procedures
HYPERTENSION
Definition: A systolic pressure reading above the 95th percentile for a
given age.

2 types:
Essential - no known cause
Secondary - results from renal disease or
another identifiable cause

Risk Factor: - Family History

- Stress
- Obesity
- High Sodium, High saturated Fat Diet
- use of tobacco
- use of hormonal contraceptives
- excess alcohol intake
- sedentary lifestyle
- aging
Signs and Symptoms: - headache in occipital region
- dizziness
- fatigue
- confusion
- palpitations
- chest pain
- hematuria
- dyspnea
- epistaxis
- blurred vision

Assessment Findings: - elevated BP on at least two (2) consecutive

occasions after initial screening
- peripheral edema
- hemorrhages
- papilledema of the exe
- pulsating abdominal mass
- bruits over abdominal aorta and femoval arteries
Therapeutic Management: - lifestyle modification
- reduction of weight in cases of obesity
- ACE inhibitor
- diuretic
- vasodilator

Nursing Intervention: - give prescribed drugs

- encourage dietary changes as appropriate
- help; identify risk factors and modify lifestyle as
appropriate
- monitor v/s especially BP

Health Teaching: - disorder, Dx, treatment

- antihypertensive therapy compliance
- examining and modifying lifestyle, including diet
- importance of follow up care
 WRITTEN OUTPUT ON KAWASAKI
DISEASE, RHEUMATIC HEART DISEASE,
ENDOCARDITIS, AND HYPERTENSION

SUBMITTED BY:
SARINES, JENNYCEL MAE C.

SUBMITTED TO:
MS. DAISY COLLEEN YOUNG-MERCADO