Rheumatic Fever

Question 1

An acute inflammatory disease of the heart potentially involving all layers (endocardium, myocardium, and pericardium)

Answer 1

Rheumatic Fever

Question 2

A chronic condition resulting from RF that is characterized by scarring and deformity of the heart valves

Answer 2

Rheumatic Heart Disease

Question 3

Risk factor of Rheumatic Fever

Answer 3

-Untreated Group A Beta-hemolytic streptococcal pharyngitis
-Poverty
-Malnutrition
-Maternal unemployment and low level of maternal education

Question 4

serves as basis for diagnosis

Answer 4

Modified Jones Criteria

Question 5

Carditis

Answer 5

Most important manifestation

-Heart murmur
-Cardiac or enlargement and HF
-Pericarditis

Question 6

Monoathritis or Polyarthritis

Answer 6

Most common manifestation

-affects the synovial membranes of the joints, causing swelling, heat, redness, tenderness, and limitation of motion
-frequently affects large joints (i.e., knees, ankles, elbows and wrist)

Question 7

Major CNS manifestation; late sign and characterized by involuntary movements, especially of the face and limbs; muscle weakness; and disturbances and gait

Answer 7

Sydenham’s chorea (St.Vitus Dance)

Question 8

Bright pink, nonpruitic, map-like macular lesions occur mainly on the trunk and proximal extremities, and may be exacerbated by heat

Answer 8

Erythema marginatum

Question 9

Firm, small, hard, painless swellings located over extensor surfaces of joints, particularly the knees, wrists, and elbows

Answer 9

Subcutaneous nodules

Question 10

Used as supplemental data to confirm the presence of RF when only one major criterion is present

Answer 10

Minor Criteria

Question 11

Evidence of Infection are confirmed by:

Answer 11

-Elevated ASO titer
-positive throat culture
-positive rapid test for GABHS

Question 12

A blood test to measure antibodies against streptolysin O, a substance produced by group A streptococcus bacteria

Answer 12

Antistreptolysin O (ASO) Titer

Question 13

Positive result of ASO titer

Answer 13

> 200 IU/ml

Question 14

Medical Management of Rheumatic Fever

Answer 14

-Antibiotic Therapy
-Salicylates (Aspirin) or NSAIDS
-Corticosteroids
-Antibiotic Prophylaxis

Question 15

Used when arthritis is the main manifestation

Answer 15

Salicylates or NSAIDs

Question 16

Used if severe carditis is present

Answer 16

Corticosteroids

Question 17

The drug of choice of antibiotic prophylaxis

Answer 17

Sumapen

Question 18

This drug is for patient with RF but without carditis until age 20 (minimum of 5 years)

Answer 18

Antibiotic Prophylaxis

Question 19

Nursing Management of Rheumatic Fever in the Disease Prevention

Answer 19

-Educate patient to seek medical attention for symptoms of “strep throat”
-Instruct patient to take full course of antibiotics for GABHS pharyngitis

Question 20

What characteristics indicate a high probability of rheumatic fever

Answer 20

The presence of two major criteria or one major and two minor criteria plus evidence of a preceding group A streptococcal infection indicate a high probability of rheumatic heart fever

Question 21

Nursing Management of Rheumatic Fever in the Acute Phase

Answer 21

-Administer salicylates, NSAIDs, and corticosteroids as prescribed
-Monitor fluid intake
-Promote optimal rest
-Position painful joints for comfort and in proper alignment
-Apply moist heat to painful joints