Kawasaki Disease — NCLEX Cheat Sheet
Coronary aneurysm = top riskAlso known as: mucocutaneous lymph node syndrome · Kawasaki syndrome · strawberry tongue illness
Use this quick-reference guide to spot, treat, and prevent Kawasaki Disease on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
🩺 Signs
- Fever > 5 days, unresponsive
- Strawberry tongue, cracked lips
- Conjunctivitis, rash, peeling palms
- Cervical lymphadenopathy, edema
🧪 Meds
- IVIG + high-dose ASPIRIN
- Aspirin OK here (anti-platelet)
✅ Do
- Echocardiogram to monitor heart
- Delay live vaccines 11mo post-IVIG
🚩 Report
- Coronary artery aneurysm
- Chest pain, MI signs
📚 Kawasaki Disease — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- A high fever lasting 5 or more days that is unresponsive to antipyretics is the hallmark.
- Bilateral nonexudative conjunctivitis (red eyes without drainage) is characteristic.
- Oral changes include a strawberry tongue and red, cracked, fissured lips.
- A polymorphous rash appears mainly on the trunk and in the groin.
- Hands and feet show erythema and edema, followed by peeling (desquamation) of the fingertips and toes during recovery.
- Cervical lymphadenopathy and extreme irritability are common; coronary artery aneurysm is the most serious complication.
Nursing priorities
What to do, in order- Administer high-dose IV immunoglobulin (IVIG) as ordered to reduce the risk of coronary artery aneurysm.
- Give aspirin as ordered for its anti-inflammatory and later antiplatelet effects, monitoring for bleeding.
- Monitor cardiac status, temperature, intake and output, and fluid balance closely.
- Provide comfort measures for irritability, oral care for cracked lips, and skin care for the rash and peeling.
- Promote rest, monitor for IVIG reactions, and prepare for echocardiography to evaluate the coronary arteries.
Red flags — report now
Escalate immediately- Signs of coronary involvement (chest pain, dysrhythmias, signs of myocardial infarction) require immediate action.
- Watch for and report any bleeding while the child is on aspirin therapy.
- Because of aspirin use, watch for signs of Reye syndrome if the child develops a viral illness such as flu or varicella.
- Persistent fever after IVIG may indicate the need for retreatment and must be reported.
Labs & values
Numbers to know- WBC: normal 5,000-10,000/mm3, often elevated
- Platelets: normal 150,000-400,000/mm3, markedly elevated in the subacute phase
- ESR and CRP: elevated, reflecting inflammation
Patient teaching
What patients must know- Give aspirin exactly as prescribed and report any unusual bruising or bleeding.
- Skin peeling on the hands and feet is expected during recovery and is not harmful.
- Avoid live vaccines (such as MMR and varicella) for about 11 months after IVIG, and keep all cardiology follow-up visits.
- Report return of fever, chest pain, irritability, or signs of a viral illness while on aspirin.
❓ Kawasaki Disease: NCLEX FAQs
What are the priority nursing interventions for Kawasaki Disease?
Administer high-dose IV immunoglobulin (IVIG) as ordered to reduce the risk of coronary artery aneurysm. Give aspirin as ordered for its anti-inflammatory and later antiplatelet effects, monitoring for bleeding. Monitor cardiac status, temperature, intake and output, and fluid balance closely. Provide comfort measures for irritability, oral care for cracked lips, and skin care for the rash and peeling.
What are the warning signs of Kawasaki Disease a nurse must report?
Signs of coronary involvement (chest pain, dysrhythmias, signs of myocardial infarction) require immediate action. Watch for and report any bleeding while the child is on aspirin therapy. Because of aspirin use, watch for signs of Reye syndrome if the child develops a viral illness such as flu or varicella. Persistent fever after IVIG may indicate the need for retreatment and must be reported.
What do I need to know about Kawasaki Disease for the NCLEX?
A high fever lasting 5 or more days that is unresponsive to antipyretics is the hallmark. Bilateral nonexudative conjunctivitis (red eyes without drainage) is characteristic. Oral changes include a strawberry tongue and red, cracked, fissured lips. A polymorphous rash appears mainly on the trunk and in the groin.
What patient teaching is important for Kawasaki Disease?
Give aspirin exactly as prescribed and report any unusual bruising or bleeding. Skin peeling on the hands and feet is expected during recovery and is not harmful. Avoid live vaccines (such as MMR and varicella) for about 11 months after IVIG, and keep all cardiology follow-up visits. Report return of fever, chest pain, irritability, or signs of a viral illness while on aspirin.
Quick Tip
A high fever lasting 5 or more days that is unresponsive to antipyretics is the hallmark.
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