Which signs and symptoms would the nurse expect to assess in a child with rheumatic fever?
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The American Journal of Nursing Vol. 46, No. 3 (Mar., 1946) , pp. 170-175 (6 pages) Published By: Lippincott Williams & Wilkins https://doi.org/10.2307/3456719 https://www.jstor.org/stable/3456719 Read and download Log in through your school or library Journal Information The American Journal of Nursing (AJN) is the oldest and largest circulating nursing journal in the world. The Journal's mission is to promote excellence in professional nursing, with a global perspective, by providing cutting edge, evidence-based information that embraces a holistic perspective on health and nursing. Clinical articles focus on acute care, health promotion and prevention, rehabilitation, emergencies, critical care, home health care, etc. Columns present additional perspectives on clinical care, such as ethics, the law, practice errors, pain and symptom management, and professional issues. Publisher Information Wolters Kluwer Health is a leading provider of information for professionals and students in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons; electronic information providers, such as Ovid Technologies, Medi-Span and ProVation Medical; and pharmaceutical information providers Adis International and Source®. Wolters Kluwer Health is a division of Wolters Kluwer, a leading multi-national publisher and information services company with annual revenues (2005) of €3.4 billion and approximately 18,400 employees worldwide. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Its depositary receipts of shares are quoted on the Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Rights & Usage This item is part of a JSTOR Collection. What is rheumatic heart disease?Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever. An immune response causes an inflammatory condition in the body which can result in on-going valve damage. What causes rheumatic heart disease?Rheumatic heart disease is caused by rheumatic fever, an inflammatory disease that can affect many connective tissues, especially in the heart, joints, skin, or brain. The heart valves can be inflamed and become scarred over time. This can result in narrowing or leaking of the heart valve making it harder for the heart to function normally. This may take years to develop and can result in heart failure. Rheumatic fever can occur at any age, but usually occurs in children ages 5 to 15 years old. It’s rare in developed countries like the United States. Who is at risk for rheumatic heart disease?Untreated or under-treated strep infections can increase the risk for rheumatic heart disease. Children who get repeated strep throat infections are at the most risk for rheumatic fever and rheumatic heart disease. What are the symptoms of rheumatic heart disease?A recent history of strep infection or rheumatic fever is key to the diagnosis of rheumatic heart disease. Symptoms of rheumatic fever vary and typically begin 1 to 6 weeks after a bout of strep throat. In some cases, the infection may have been too mild to have been recognized, or it may be gone by the time the person sees a doctor. These are the most common symptoms of rheumatic fever:
Symptoms of rheumatic heart disease depend on the degree of valve damage and may include:
How is rheumatic heart disease diagnosed?People with rheumatic heart disease will have or recently had a strep infection. A throat culture or blood test may be used to check for strep. They may have a murmur or rub that may be heard during a routine physical exam. The murmur is caused by the blood leaking around the damages valve. The rub is caused when the inflamed heart tissues move or rub against each other. Along with a complete medical history and physical exam, tests used to diagnose rheumatic heart disease may include:
How is rheumatic heart disease treated?Treatment depends in large part on how much damage has been done to the heart valves. In severe cases, treatment may include surgery to replace or repair a badly damaged valve. The best treatment is to prevent rheumatic fever. Antibiotics can usually treat strep infections and keep rheumatic fever from developing. Anti-inflammatory drugs may be used to reduce inflammation and lower the risk of heart damage. Other medicines may be needed to manage heart failure. People who have had rheumatic fever are often given daily or monthly antibiotic treatments, possibly for life, to prevent recurrent infections and lower the risk of further heart damage. To reduce inflammation, aspirin, steroids, or non-steroidal medicines may be given. What are the complications of rheumatic heart disease?Some complications of rheumatic heart disease include:
Can rheumatic heart disease be prevented?Rheumatic heart disease can be prevented by preventing strep infections or treating them with antibiotics when they do occur. It’s important to take antibiotics as prescribed and to complete them as instructed, even if you feel better after a few days. Living with rheumatic heart diseaseYou will need to have ongoing follow-up with your healthcare provider to check the condition of your heart. Depending on the amount of heart damage, you may have some activity restrictions. Your healthcare provider may recommend that you take antibiotics for an extended period to prevent another infection of rheumatic fever. When should I call my healthcare provider?If your symptoms get worse or you have new symptoms, call your healthcare provider. Key points
Stay on Top of Your Heart HealthIf you have a new or existing heart problem, it's vital to see a doctor. Our heart health checklist can help you determine when to seek care. What are symptoms of rheumatic fever in children?Symptoms may include joint inflammation, small, hard bumps under the skin, jerky movements, a rash and fever. Treatment includes antibiotics, anti-inflammatory medicine and bed rest. Your child will need to have ongoing treatment to stop the disease from coming back.
What is the sign and symptoms of rheumatic fever?Symptoms of rheumatic fever
redness, pain and swelling of your joints (arthritis), usually ankles, knees, wrists or elbows. pain in your chest, breathlessness and a fast heart rate. jerky, uncontrollable movements in your hands, feet and face. tiny bumps under your skin.
When assessing a child for signs and symptoms of rheumatic fever which symptoms should the nurse anticipate?Your child's healthcare provider will look for:. Inflammation of the heart.. Inflammation of more than one joint.. Unusual jerky movements.. Small, hard bumps under the skin.. Red, irregular rash.. Fever.. Pain in one or more joints.. Previous inflammation of the heart.. What is the commonest clinical feature in children with rheumatic fever?Polyarthritis is the most common symptom and is frequently the earliest manifestation of acute rheumatic fever (70-75%). Characteristically, the arthritis begins in the large joints of the lower extremities (ie, knees, ankles) and migrates to other large joints in the lower or upper extremities (ie, elbows, wrists).
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