The Primary Diagnosis Of Kawasaki Disease Assignment Paper

The Primary Diagnosis Of Kawasaki Disease Assignment Paper

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Patient: The patient was a three-year-old Native Alaska boy brought to the hospital by his parents due to a persistent fever lasting more than five days. The child had a high fever that was not responsive to over-the-counter medication, and he also had a rash on her body. Upon further examination, the child had red eyes, a red and swollen tongue, and cracked lips. The pediatrician suspected the child had Kawasaki disease and immediately ordered a series of tests to confirm the diagnosis (Singh et al., 2018)The Primary Diagnosis Of Kawasaki Disease Assignment Paper. Blood tests showed elevated levels of inflammatory markers, and an echocardiogram revealed a dilated coronary artery, a potential complication of Kawasaki disease.

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Primary Diagnosis: Kawasaki disease ICD: M30.3

Differential Diagnosis:
1. Scarlet fever ICD: A38. 9
2. Infantile polyarteritis nodosa ICD: M30.0
3. Measles ICD: B05.9

I need the Primary diagnosis and differential diagnosis defined and explained. I also need a treatment plan for the primary diagnosis which should include proper testing, procedures, medications, patient teaching, and health promotion information.

*I HAVE ATTACHED A TEMPLATE TO FOLLOW FOR THIS ASSIGNMENT

Primary Diagnosis

1. What is the ICD-10 code:

The client’s primary diagnosis is Kawasaki disease ICD: M30.3

1. The rationale for the primary diagnosis

The client was a 3yo Native Alaska male who was accompanied by his parents to the hospital. During the clinical assessment, his parents reported a persistent high fever that had lasted for more than five days. They further reported that the fever was not responsive to over-the-counter medication. The client also had a rash on his body. A physical examination of the child’s body revealed red eyes, a swollen and red tongue, and cracked lips. Based on the medical history collected during the clinical interview and physical examination results, the pediatrician suspected Kawasaki disease as the client’s current diagnosis. In children, Kawasaki disease is characterized by high fever, ranging from 102.0° F to 104.0° F and lasting for a minimum of five days, red eyes and tongue, and swollen feet and hands accompanied by skin peeling (Colomba et al., 2018)The Primary Diagnosis Of Kawasaki Disease Assignment Paper. The client had a persistent high fever that lasted for five days, red eyes, and a swollen and red tongue, qualifying for Kawasaki disease as the primary diagnosis.

However, the clinician ordered different diagnostics to confirm the suspected diagnosis. Blood test results indicated inflammatory markers elevation. According to Wessels and Bingler (2022), Kawasaki disease in children leads to the elevation of inflammatory markers in the body. Additionally, an echocardiogram indicated a dilated coronary artery. Tascón et al. (2018) report that Kawasaki disease is the primary cause of acquired heart disease in children. Therefore, dilation in the client’s coronary artery is a potential complication of Kawasaki disease.

1. CPT codes and any procedural codes

CPT codes are assigned to various diagnostics and treatment procedures for billing purposes. In children, various diagnostic tests are ordered to confirm Kawasaki disease. First, a lab test specifically a complete blood count (85027) should be ordered to evaluate elevation in inflammation makers. Elevation in the level of inflammation makers in the blood sample indicated Kawasaki disease. The healthcare provider should also order an echocardiogram (93308) to confirm dilation of the coronary artery, which is a significant symptom of Kawasaki disease in children.

2. Guidelines were used to develop this primary diagnosis. 5 points

The client’s primary diagnosis is Kawasaki disease, which was diagnosed based on different guidelines. The first diagnostic criterion is subjective data collected from the client’s parents during clinical interviews. They reported that the client had experienced a persistent high fever for five days. Kawasaki disease in children is primarily characterized by high fever, ranging from 102.0° F to 104.0° F that lasts for a minimum of five days (Colomba et al., 2018)The Primary Diagnosis Of Kawasaki Disease Assignment Paper. Secondly, Kawasaki disease is diagnosed based on physical examination findings. Upon examining the child’s body, the healthcare professional noticed red eyes, a swollen and red tongue, and cracked lips. Colomba et al. (2018) report that red eyes and tongue and swollen feet and hands accompanied by skin peeling are common symptoms in children with symptoms of Kawasaki disease. Lastly, this condition was diagnosed based on diagnostic findings, including blood tests and an echocardiogram. Elevation of inflammation makers and dilation of the coronary artery indicated Kawasaki disease. Therefore, Kawasaki disease qualifies as the client’s primary diagnosis based on medical history, physical examination findings, and diagnostics results.

3. Differential diagnoses (ddx)with rationale

DDx#1: Scarlet fever ICD: A38. 9

DDx#2: Infantile polyarteritis nodosa ICD: M30.0

DDX #3:  Measles ICD: B05.9

Scarlet fever (A38. 9): This condition is considered the first potential differential diagnosis for this client. In children, scarlet fever is caused by group A strep pharyngitis and is characterized by a red sore throat, high fever (101°F or more) or chills, whitish coating on the tongue at the initial stages of the disease, bumpy and red tongue, a red skin rash, and swollen glands in the neck (Brockmann et al., 2018)The Primary Diagnosis Of Kawasaki Disease Assignment Paper. The client qualifies for this diagnosis due to the presence of high and persistent fever and a swollen and red tongue. Nonetheless, Scarlet fever is ruled out since most significant symptoms, including a whitish coating on the tongue, a red skin rash, and swollen glands in the neck are absent.

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Infantile polyarteritis nodosa (M30.0): This condition is another potential diagnosis for this client. In children, infantile polyarteritis nodosa is characterized by fever, anorexia, malaise, weight loss, and abdominal pain (Loureiro et al., 2019). The client’s parents reported high and persistent as the chief complaint, qualifying for this diagnosis. However, infantile polyarteritis nodosa is ruled out due to the absence of other significant symptoms, including anorexia, malaise, weight loss, and abdominal pain.

Measles (B05.9): The client’s last potential diagnosis is Measles. The most common symptoms of measles in children include high fever, runny nose, cough, and watery eyes (Islam et al., 2023). In most cases, measles symptoms appear between 7 and 14 days after being infected (Islam et al., 2023). The client’s parents reported high and persistent fever during the clinical assessment, qualifying for this diagnosis. However, measles is disqualified as a potential diagnosis for this client due to the absence of significant symptoms, including a runny nose, cough, and watery eyes.

4. Treatment Plan
   1. Medications: The client should be given intravenous gamma globulin (IVIG) and aspirin 650 mg every 4 to 6 hours. IVIG prevents an abnormal enlargement of the coronary vein and reduces the duration of fever, while a high-dose aspirin should be administered due to its efficacy in controlling inflammation and fever in children at the initial stages of Kawasaki disease (Kuo et al., 2018)The Primary Diagnosis Of Kawasaki Disease Assignment Paper.
   2. education: The client should continue taking high-dose aspirin orally to treat inflammation until improvement in the inflammation is detected through blood tests.
   3. Additional Ancillary tests: Various diagnostics should be ordered during the client’s treatment. First, the healthcare provider should order lab tests, including blood and urine tests to check for inflammation. The findings are also used to rule out other potential health problems. Electrocardiography (ECG) should also be ordered to monitor the electrical activity of the client’s heart. Lastly, the healthcare provider should order cardiac catheterization to check the structure of the client’s coronary arteries.
   4. Referrals: This should be referred to a cardiologist for further examination of the changes in the structure of blood vessels and activities of the cardiac muscle.
   5. Follow-ups: The client should return to the clinic after two weeks to allow the healthcare provider to check for improvement in his inflammation.
5. Social Determinants of Health, Health Promotion and Pt risk factors
   1. Social Determinants of Health: Children with low socioeconomic status delay in seeking treatment, increasing the risk of adverse health outcomes, including longer stay due to severe inflammation.
   2. Health Promotion: The client should be monitored closely for early detection of danger signs such as faster breathing and shortness of breath.
   3. Risk Factors: The most significant risk factor for Kawasaki disease is young age since this disease is common in children aged between 3 and 5 years (Wessels & Bingler, 2022)The Primary Diagnosis Of Kawasaki Disease Assignment Paper.

References

Brockmann, S. O., Eichner, L., & Eichner, M. (2018). Constantly high incidence of scarlet fever in Germany. The Lancet Infectious Diseases, 18(5), 499-500.

Colomba, C., La Placa, S., Saporito, L., Corsello, G., Ciccia, F., Medaglia, A., … & Cascio, A. (2018). Intestinal involvement in Kawasaki disease. The Journal of Pediatrics, 202, 186-193.

Islam, M. R., Dhar, P. S., & Rahman, M. M. (2023). Recent measles (rubeola) outbreak: etiology, symptoms, prevention, treatment, complications, and advice for medical professionals. International Journal of Surgery, 109(2), 123-125.

Kuo, H. C., Guo, M. M. H., Lo, M. H., Hsieh, K. S., & Huang, Y. H. (2018). Effectiveness of intravenous immunoglobulin alone and intravenous immunoglobulin combined with high-dose aspirin in the acute stage of Kawasaki disease: study protocol for a randomized controlled trial. BMC Pediatrics, 18(1), 1-6.

Loureiro, G., Oliveira, D., Ganhão, S., Aguiar, F., Rodrigues, M., & Brito, I. (2019). Ab1039 Ada2 Deficiency Presenting As Infantile Polyarteritis Nodosa. Annals of Rheumatic Disease, 78 (2), 2-4.

Tascón, A. B., Malfaz, F. C., Sombrero, H. R., Fernández-Cooke, E., Sánchez-Manubens, J., Picarzo, J. P. L., … & Sombrero, M. H. R. (2018). National consensus on the cardiological treatment and follow-up of Kawasaki disease. Anales de Pediatría (English Edition), 89(3), 188-e1.

Wessels, P. A., & Bingler, M. A. (2022). A comparison of Kawasaki Disease and multisystem inflammatory syndrome in children. Progress in Pediatric Cardiology, 65, 101516.

Management Plan Template– must include these headings: This section is worth 40 points.

1. Primary Diagnosis—10 points (all areas must be addressed)
   1. What is the ICD-10 code:
   2. What is your rationale for arriving at this primary diagnosis? You must integrate the pertinent finding and support your rationale with evidence-based literature (resources)
   3. . Include CPT codes, and any procedural codes (such as nurse lab draws, vaccinations given, biopsies).

2. Guidelines used to develop this primary diagnosis. 5 points

3. Differential diagnoses (ddx)with rationale and resources. Minimum of 3-5 differentials (primary dx does not count as a differential). For well-child visit, if there are no other health issues, then differentials are not needed. 5 points The Primary Diagnosis Of Kawasaki Disease Assignment Paper

DDx#1–

DDx#2-

DDX #3-

4. Medications including OTC, dosage and education, additional ancillary

 tests needed, referrals and follow up – 10 pts 

1. Medications-
2. education-
3. Additional Ancillary
4. Referrals-
5. Follow-ups-
6. Social Determinants of Health to consider, Health Promotion and Pt risk factors – 5 pts
   

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1. Social Determinants of Health
2. Health Promotion-
3. Risk Factors—

REFERENCES (USE APA)

Must have 3 and must show that it is cited within your text. Please understand that references provide the information necessary for readers to identify and retrieve each work cited in the text. If your references are not cited within your text, then points will be deducted.

**NO MAYO CLINIC, no pt. education websites, must be peer-reviewed literature. The Primary Diagnosis Of Kawasaki Disease Assignment Paper