NCLEX High Yield: Oral Thrush, Reye Syndrome, and Kawasaki Disease

Practice questions covering immunosuppression-related oral thrush, the dangers of Reye Syndrome, and the clinical management of Kawasaki Disease for the NCLEX exam.

How do corticosteroids lead to opportunistic infections like oral thrush?

They suppress the immune system's activity and ability to fight off normal flora, allowing the flora to overgrow into opportunistic pathogens.

What is the specific pathogen responsible for oral thrush?

Candida Albicans (Candidiasis).

What patient education is essential for those using an inhaled corticosteroid (ICS) for asthma?

Educate the patient to rinse out their mouth after use so the steroid doesn't stay in the mouth and suppress the ability to fight normal flora.

What are the clinical signs of oral thrush in the oral cavity?

White, cottage cheese-like overgrowth on the mucosa.

What are the steps for administering Nystatin fluid for oral thrush?

Shake the medication, have the patient swish and swallow for several minutes (as Candida can grow into the esophagus), soak dentures if applicable, and inspect the oral cavity for irritation, blisters, or ulcers.

Why should Aspirin (ASA) and Bismuth Salicylate be avoided in children with viral infections like Varicella or Influenza?

It can cause Reye Syndrome, which leads to encephalopathy and fatty liver (hepatotoxicity) and is deadly.

What is the only exception mentioned where Aspirin (ASA) is given to a child despite the risk of Reye Syndrome?

Kawasaki Dz (Kawasaki Disease).

What is the underlying pathophysiology of Kawasaki Dz?

Vasculitis, which is the inflammation of the vasculature that compromises the structure of the vessels.

In Kawasaki Dz, what does the 'CRASH' acronym stand for in terms of signs and symptoms?

Conjunctivitis, Rash, Adenopathy, Strawberry tongue, and Hands + feet swelling.

What are the primary treatments for Kawasaki Dz?

IVIG and ASA (Aspirin).

What is the most critical Field of Action (FOA) or concern in Kawasaki Dz?

Coronary Artery Aneurysm, which can lead to rupture and hemorrhage.

What are the secondary concerns for a Kawasaki Dz patient with temperature between $104\text{ and }105^{\circ}F$?

High fever leading to AMS (Altered Mental Status) or seizure.