Which of the following is the most characteristic finding of Kawasaki disease (KD) upon assessment?
a. hands and feet that are tensely edematous and very erythematous with desquamation beginning by day 10
b. hives that come and go and do not follow the usual pattern--for example, half the lip or one eyebrow
c. projectile vomiting when the child is not held upright during feedings
d. tendency to squat quite frequently and for the lips to turn blue
A
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A Correct. The most characteristic finding of KD are changes in the hands and feet that are tensely edematous and very erythematous with desquamation beginning by day 10 . This starts just under the finger and toenails and progresses to involve the palms and soles, with skin peeling in sheets.
B Incorrect. Hives that come and go and do not follow the usual pattern--for example, half the lip or one eyebrow--are not characteristic findings of KD.
C Incorrect. Projectile vomiting when the child is not held upright during feedings is not a characteristic finding of KD, but of pyloric stenosis (a gastrointestinal alteration)
D Incorrect. The tendency to squat quite frequently and for the lips to turn blue is characteristic of Tetralogy of Fallot, a congenital cardiac anomaly.
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