Question

4. Jennifer Collins, 13 years old, is admited to the pediatric floor with a diagnosis of probable acute rheumatic fever. (Learning Objectives 2, 4, 6, 7, and 8) A. What would the nurse include when performing an initial assessment? B. What tests would the nurse expect to be done on Jennifer? The diagnosis of acute rheumatic fever is confirmed. C. What would the nurse be sure to include in the discharge teaching plan for Jennifer and her family?

Answer 1

A. Rheumatic fever is an autoimmune inflammatory disease which affects multiple organs like heart, bones and soft tissues, central nervous system and skin. Therefore the nurse should inspect every organ system for signs and symptoms.  

The initial assessment should include looking for symptoms like fever, joint pain, polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum. Assess child’s mobilty and physical activity.

The pain assessment should include patient rating on pain assessment scale from 0-10.

B. Diagnostic tests include blood tests like CBC, ESR.

Rapid streptococcal test and antistreptoccal antibpdy test are performed

synovial biopsy is performed

chest xray

echocardiography and doppler to detect any cardiac manifestations

C. Patient education includes:

- emphasise on timely evaluation of the patient

- teach proper and timely administration of anti inflammatory therapy.

- educate patient on importance of prophylactic treatment

- educate patient about signs and symptoms of rheumatic fever and streptococcal pharyngitis and importance of immediate treatment.

- emphasise on proper rest till all laboratory values and symptoms return to normal

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