What is a priority nursing diagnosis for the subacute stage of Kawasaki disease?

• A. High risk for altered tissue perfusion, cardiopulmonary.
• B. Alterations in skin integrity.
• C. Risk for imbalanced body temperature, hyperthermia.
• D. High risk for fluid volume deficit.

Answer: (A)

Kawasaki disease involves systemic inflammation of the blood vessels, and while fever may subside in the subacute stage, the heart and its circulation can still be affected. The most critical and protective concern during this phase is preserving tissue perfusion because impaired cardiac function or coronary involvement can quickly compromise oxygen delivery to tissues. Therefore, a nursing diagnosis focusing on a high risk for altered tissue perfusion, cardiopulmonary, best captures the main risk in the subacute stage and guides vigilant monitoring of heart and lung status, including vital signs, pulses, capillary refill, oxygenation, and potential signs of heart failure.

Skin peeling and desquamation are characteristic of the subacute phase but do not carry the same immediate risk to life as perfusion abnormalities. Hyperthermia is typically resolved by this stage, and fluid volume deficit is less central than the risk to cardiac output, though it remains important to monitor hydration.