Which symptom is most commonly associated with Kawasaki disease in children?

NCL (Northern Coalfields Limited)-NO

Child Health Nursing (Pediatrics)

Easy

Appeared in: NCL (Northern Coalfields Limited)-NO

Explanation

Strawberry tongue is a classic and highly characteristic sign of Kawasaki disease, an acute vasculitis affecting children.
It is one of the five principal clinical criteria used for diagnosis, specifically falling under 'changes of mucosae of oropharynx'.
The appearance is due to inflammation of the fungiform papillae of the tongue, causing them to become enlarged and reddened, resembling a strawberry.
Its presence during the acute febrile phase is a strong indicator for the diagnosis.

Option A: While anemia can develop during the course of Kawasaki disease, which may cause skin pallor, it is a secondary and non-specific finding, not a primary or common diagnostic sign.
Option C: Night sweats are not a recognized symptom of Kawasaki disease.
Option D: Although joint pain (arthralgia) and arthritis can occur in Kawasaki disease, they are more typical of the subacute phase (after the first 10 days) and are not one of the five principal criteria for initial diagnosis.

Visual 1: Photograph - A close-up image of a child's tongue showing the characteristic bright red color and prominent papillae of a 'strawberry tongue' seen in Kawasaki disease.
Visual 2: Infographic - A chart illustrating the five main diagnostic criteria for Kawasaki disease (CRASH: Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/foot changes) along with the requirement of fever.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of Kawasaki Disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must maintain a high index of suspicion for Kawasaki disease in any child with prolonged fever (5+ days) to ensure early diagnosis and treatment.
Prompt administration of Intravenous Immunoglobulin (IVIG) within the first 10 days of illness is critical to reduce the risk of coronary artery aneurysms, the most serious complication.
Nursing care involves meticulous monitoring of vital signs, cardiac status, and symptom progression, as well as providing comfort measures for fever, irritability, and mucosal discomfort.

How to Approach the Question

This is a factual recall question asking for a classic symptom of a specific pediatric illness.
First, identify the core condition mentioned in the stem: Kawasaki disease.
Recall the key diagnostic criteria for this disease. A helpful mnemonic is 'CRASH and burn': Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/foot changes, and 'burn' for the high fever.
Evaluate each option against these hallmark signs.
Recognize that 'Strawberry tongue' is a direct match to one of the key criteria (the 'S' in CRASH).
Eliminate the other options as they are either non-specific (skin pallor), incorrect (night sweats), or less central to the initial diagnosis (joint pain).

Concept Tested & Keywords

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