In a newly admitted 2-year-old with Kawasaki disease, which intervention should be the priority?

In a newly admitted 2-year-old with Kawasaki disease, which intervention should be the priority?

• A. Taking vital signs every 6 hours
• B. Monitoring intake and output every hour
• C. Minimizing skin discomfort
• D. Providing passive ROM exercises

Answer: (B)

In Kawasaki disease, the first priority is ensuring the child remains adequately hydrated because fever and poor oral intake put a toddler at high risk for dehydration and decreased circulating volume. Monitoring intake and output hourly provides real-time information about fluid balance, guiding how much fluid to give and when to adjust that fluid therapy to maintain perfusion. This directly supports cardiovascular stability, which is crucial in the acute phase of Kawasaki disease before starting treatments like IVIG. Taking vital signs every 6 hours is important, but it doesn’t reveal dehydration risk as clearly as hourly I&O. Minimizing skin discomfort and passive range-of-motion exercises are supportive and helpful for comfort and mobility, but they don’t address the immediate need to preserve fluid balance and circulation in this scenario.

In Kawasaki disease, the first priority is ensuring the child remains adequately hydrated because fever and poor oral intake put a toddler at high risk for dehydration and decreased circulating volume. Monitoring intake and output hourly provides real-time information about fluid balance, guiding how much fluid to give and when to adjust that fluid therapy to maintain perfusion. This directly supports cardiovascular stability, which is crucial in the acute phase of Kawasaki disease before starting treatments like IVIG.

Taking vital signs every 6 hours is important, but it doesn’t reveal dehydration risk as clearly as hourly I&O. Minimizing skin discomfort and passive range-of-motion exercises are supportive and helpful for comfort and mobility, but they don’t address the immediate need to preserve fluid balance and circulation in this scenario.