Kawasaki Disease - Raiza

8/8/2019 Kawasaki Disease - Raiza

1/17

Raiza Nikkita V. Pascual


2/17

y Mucocutaneous Lymph Node Syndrome or known asKawasaki Disease, is an acute, febrile, multi systemdisorder that occurs almost exclusively in children

before the age of puberty.

y It is the leading cause of acquired Heart Disease inchildren 2yrs of age and younger.

y It was first described in 1965 by Dr. TomisakuKawasaki in Japan.


3/17

y The cause of Kawasaki Disease remains unknown.

However, recent evidence suggests it is an Immune

Mediated Vasculitis ( inflammation of blood vessels )

triggered by an acute infection or by a bacterial toxin.


4/17

Risk Factors

Unknown, but it apparently develops in genetically

predisposed individualsafterexposuretoanas-yet-unidentified infectiousagent

Seen most frequently inchildrenyoungerthan

fiveyearsold Peak incidence is in boysunder fouryearsof age


5/17

High fever (39-40C) that does not respond to

antipyretic

Conjunctival infection(redness of conjunctiva)

Oral changes (strawberry tongue & red cracked lips)

Skin desquamates on the palms & sole of the feet

Joints may swell & reddened (arthritic) Variety of rashes occur (often confined to diaper area)


6/17


7/17

1. Electrocardiography ( ECG )

Graphicall y records the electrical current &

generated b y the Heart & measured by electrodesconnected to an amplifier & strip chart recorder.

Purpose:

- to identif y conduction abnormalities, cardiacarrythmias, myocardial ischemia or infarction.

- to document pacemaker performance.


8/17

Nsg. Responsibilities:

- assist the patient in supine or semi fowlers position.

- expose the chest, ankles & wrists.

- place lead properly.

- disconnect the equipment, remove the electrodes &

remove the gel w/ a moist cloth towel.


9/17

2. Echocardiography ( ECHO )N

oninvasive test examines the size, shape and motionor cardiac structures.

Purpose:

- to diagnose & evaluate valvular abnormalities.- to measure & evaluate the size of the heartschambers & valves.

Nsg. Responsibilities:- assists the child to remain still.

- remove the conductive gel from the patients skinafter the test.


10/17

EDICATION1. Aspirin ( AcetylsalicylicAcid )

C = Analgesic&Antipyretic

A = Thoughttoproduceanalgesia by blocking pain impulses, by

inhibiting synthesisof prostaglandin intheCN

Sorof othersubstancesthatsensitizepainreceptorstostimulation. Mayrelieve fever bycentral action inthehypothalamicheatregulating center&exert itsanti-inflammatoryeffect bysynthesisof inhibiting prostaglandin&thatof othermediatorsof the inflammatoryresponseas well. In low doses, italso

appearsto impedeclotting bypreventing formationof aplateletaggregating substances.

I = Poly-arthriticor inflammatoryconditions.

Mildpainor fever

Kawasaki Disease


11/17


12/17

NURSING DIAGNOSIS

1. Risk for IneffectivePeripheral TissuePerfusion

R/T inflammationof blood vessels

Goal:

thechild will maintainadequatetissueperfusionduring thecourseof illness.

Nsg. Intervention: observe forsignsof heart failure&edema.

inspectextremities forcolor&palpate for warmth&capillary filling intoes& fingers.

if thechild isdeveloping myocarditis, bealert forchestpain, arrythmias & ECGchanges.


13/17

2. AcutePain R/T fever, skinmanifestationsandjointinflammation.

Goal:Thechild will restcomfortably& will express

decreasedpain.

Nsg. Intervention:

providecomfortmeasuressuchasuseof heat/cold

packs, touch, repositioning. encouragedadequaterestperiods.

administeranalgesicsas indicated.


14/17

3. Impaired Oral Mucus Membrane

Goal:Identifyspecific interventiontopromotehealthy

oral mucosa.

Nsg. Intervention:encourageadequate fluids.lubricate lips w/ lip balm&otheroral lubricant

solution.encouragethechildtocontinue brushing histeeth.


15/17

With earl y treatment, rapid recovery from theacute symptoms can be expected and the risk ofcoronary artery aneurysms greatl y reduced.

Untreated, the acute symptoms of Kawasakidisease are self-limited ( the patient will recovereventually), but the risk of coronary arteryinvolvement is much greater.


16/17

ResearchJanuary 2009

For the new study, the international consortiumcombined their patients to perform a genome-wideassociation study in 119 Caucasian KD cases and 135matched controls from Australia, Holland, USA and theUK. They looked at 250000 genetic variants in eachpatient and uncovered the most significant genes thatappeared to be involved in Kawasaki disease. They then

replicated this in an independent cohort of a total of893 KD cases plus population and family controls.The researchers are now planning to anal yse an Asiancohort of people with Kawasaki disease, to see if theirresults can be replicated in this population.


17/17

THANK YOU!

Kawasaki Disease - Raiza

Documents

Transcript of Kawasaki Disease - Raiza