Question

Jennifer Collins, 13 years old, is admitted to the pediatric floor with a diagnosis of probable acute rheumatic fever.

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. Initial assessment on Jennifer Collins include -------

• Take a proper health history which involves whether the patient had previous history of strept throat infection.
• Whether the infection was cured completely.
• Whether antibiotic therapy was fully taken or discontinued.
• Also, in present health history assess for the skin changes. If there are small pink erythematic bruishes on skin.
• Presence of joint pain.
• Auscultation of heart may reveal murmur if heart is affected.

b. Tests that has to be done on Jennifer include:

• Rapid antigen detection test.
• Throat culture and sensitivity.
• CRP and ESR tests which are usually elevated.
• Heart reactive antibodies.
• Chest Xray and echo

Rapid antigen detection test and throat culture and sensitivity usually shows positive for streptococci.

c. Discharge plan for Jennifer diagnosed with Rheumatic fever include -----

• Take antibiotics as prescribed. Do not discontinue the antibiotic therapy to avoid complications.
• If there is any sore throat, ensure to get it checked and treated fully.
• The recovery from Rheumatic fever takes upto 6 months based on how heart is affected. Get regular follow-up and echo done to know the condition of the heart.
• Explain about analgesic to be taken to relieve pain.
• Maintain personal hygiene specially brushing the teeth twice a day to prevent infections that can cause complications in heart .

Thank you.