In: Nursing
A mother has come to urgent care with her 8 year old daughter because of a rash and swollen joints. When asked about past illness, the mother relates that the daughter recently had a cold sore throat but they went away. She never took her daughter to the doctor just kept her in bed a couple days with a fever and had her gargle with warm salt water. mom states to you, "all the kids are sharing and no need to run to the doctor. It will go away eventually".
a) What are some immediate concerns?
b) What assessment should the nurse do or prepare the patient for?
c) What potential treatment should the nurse prepare the mother and the child for its rheumatic fever?
A) the immediate concern of patient is rheumatic heart disease . Rheumatic fever in patient can Leads the damage of endocardium layer of heart and valves . Result in decreased heart functioning.
B ) nurse should assess the fever with weakness ,malaise , weight loss , anorexia . And any skin problem like erythema , subcutaneous nodules, marginatum, and assess chorea to assess symptoms of Rheumatic heart disease.
Nurse should prepare patient for
1) Throat culture. For group A , Beta hemolytic streptococcus bacteria.
2) ECHO to assess valve Damage and heart damage , any rythm changes
3) blood test as ESR elevation , C reactive protein and leucocytosis.
4) Chest X rays to see enlarged heart .
C) patient must be give
1) antibiotics ,for reducing activity streptococcus bacteria . Mostly benzathine penicillin G is given .
2 ) corticosteroids to reduce the joints inflammation and also to reduce inflammation of endocardium layer of heart and enhance output of heart .
PLEASE PLEASE UPVOTE IF FIND IT SATISFACTORY, COMMENT IF ANY DOUBT.