Rheumatic Fever Flashcards
An acute inflammatory disease of the heart potentially involving all layers (endocardium, myocardium, and pericardium)
Rheumatic Fever
A chronic condition resulting from RF that is characterized by scarring and deformity of the heart valves
Rheumatic Heart Disease
Risk factor of Rheumatic Fever
-Untreated Group A Beta-hemolytic streptococcal pharyngitis
-Poverty
-Malnutrition
-Maternal unemployment and low level of maternal education
serves as basis for diagnosis
Modified Jones Criteria
Carditis
Most important manifestation
-Heart murmur
-Cardiac or enlargement and HF
-Pericarditis
Monoathritis or Polyarthritis
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)
Major CNS manifestation; late sign and characterized by involuntary movements, especially of the face and limbs; muscle weakness; and disturbances and gait
Sydenham’s chorea (St.Vitus Dance)
Bright pink, nonpruitic, map-like macular lesions occur mainly on the trunk and proximal extremities, and may be exacerbated by heat
Erythema marginatum
Firm, small, hard, painless swellings located over extensor surfaces of joints, particularly the knees, wrists, and elbows
Subcutaneous nodules
Used as supplemental data to confirm the presence of RF when only one major criterion is present
Minor Criteria
Evidence of Infection are confirmed by:
-Elevated ASO titer
-positive throat culture
-positive rapid test for GABHS
A blood test to measure antibodies against streptolysin O, a substance produced by group A streptococcus bacteria
Antistreptolysin O (ASO) Titer
Positive result of ASO titer
> 200 IU/ml
Medical Management of Rheumatic Fever
-Antibiotic Therapy
-Salicylates (Aspirin) or NSAIDS
-Corticosteroids
-Antibiotic Prophylaxis
Used when arthritis is the main manifestation
Salicylates or NSAIDs
Used if severe carditis is present
Corticosteroids
The drug of choice of antibiotic prophylaxis
Sumapen
This drug is for patient with RF but without carditis until age 20 (minimum of 5 years)
Antibiotic Prophylaxis
Nursing Management of Rheumatic Fever in the Disease Prevention
-Educate patient to seek medical attention for symptoms of “strep throat”
-Instruct patient to take full course of antibiotics for GABHS pharyngitis
What characteristics indicate a high probability of rheumatic fever
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
Nursing Management of Rheumatic Fever in the Acute Phase
-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
