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4 Acute Rheumatic Fever Nursing Care Plans

Acute rheumatic flush is an irritant autoimmune indisposition that betides 2 to 6 weeks subjoined an untreated or inferiortreated assemblage A beta-hemolytic streptococcal taint. It affects the disposition, junctions, mediate nervous system (CNS), and peel. It is anticipateed by ready texture of the taint through a prophylaxis of antibiotics amid 9 days of onset of streptococcal taint anteriorly prefer complications can disclose. Beprinciple rheumatic disposition indisposition does not betide succeeding singly one invasion and conclusion are impressible to frequent invasions of rheumatic flush, it is animate that an modetrounce accident is diagnosed and treated, and that crave-term insurance therapy (5 years or more) is attached subjoined the quick air. The signs and symptoms of rheumatic flush are classified into superior manifestations (polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum) and younger manifestations (fever, arthralgia, ECG and laboratory modifys) according to the revised Jones criteria. The personality is naturalized upon the adjacentness of 2 superior manifestations, or 1 superior and 2 younger manifestations, befriended by indication of a anterior assemblage a streptococcal taint is speaking of quick rheumatic flush.

Nursing Preservation Plans

Nursing preservation planning goals for a offshoot delay quick rheumatic flush embrace reducing self-denial, conserving air, promoting zeal tolerance, and providing direction environing the indisposition, texture and contrariant measures demanded to shirk repose and approvely complications. Here are immodest (4) nursing preservation plans and nursing personality for quick rheumatic flush:

Acute Pain

Nursing Diagnosis May be cognate to
  • Inflammation
  • Arthralgia
Possibly indicationd by
  • Verbal style of self-denial
  • Guarding and protective bearing of self-denialful junctions
  • Warmth at fictitious junctions
  • Edema
  • Redness
Desired Outcomes
  • Child conciliate verbalize adjacent self-denial by using a layer of 1 to 10.
  • Child conciliate appear relaxed delayout protecting.
  • Child’s junctions conciliate not beseem inflamed, red, or interested.
Nursing Interventions Rationale
Assess the offshoot’s self-denial cognizance using an misapply layer total 2 to 3 hours. Provides notification environing the self-denial flatten of the offshoot.
Assess modifys in bearing, such as intelligent cry, sensibility, impatience, denial to stir, facial grimace, aggressive or dependent bearing. Nonverbal self-denial styles that are age-cognate as offshoot or infant may be insufficient to describe self-denial; fear and anxiety associated delay self-denial principle modifys in bearingal responses.
Examine fictitious junctions, rank of junction self-denial, flatten of junction movement. Provides postulates environing pathologic modifys in junctions; reversible junction involvement usually affecting comprehensive junctions, such as knees, hips, wrists, and elbows; an extension in collection of fictitious junctions betides balance a era of era.
Administer salicylates and anti- irritant medications as prescribed, and warn offshoot that the medication conciliate retrench the self-denial; administer a sustained- action analgesic anteriorly bedera or 1 hour anteriorly anticipated stirment. Relieves self-denial, inflammation in junctions and afford intermission and self-satisfaction.
Elevate complicated extremities aloft disposition flatten. Improves vogue to the disposition to remit edema.
Maintain bed intermission during the quick stage of the indisposition. Promotes succor of junction self-denial principled by stirment.
Advise positional modifys total 2 hours occasion maintaining organization alignment. Prevents contractures and promotes self-satisfaction.
Apply bed cradle inferior delayout covers balance self-denialful junctions. Avoids hurry on self-denialful parts.
Assist in soft handling and sustaining of organization compressiveness. Prevents extra self-denial to fictitious compressiveness.
Provide toys, games for calm, sedentary play. Provides diversionary zeal to distract from the self-denial.
Encourage the use of nonpharmacologic interventions such as imagery, relaxation, inattention, cutaneous stimulation, excitement contact. Provides affixed measures to retrench self-denial cognizance.
Stress the avail of poor zeal or whole of junction stirment undisputed. Prevents extension or exacerbation of self-denial.
Teach parents and offshoot of the demand for analgesia and that it conciliate acceleration him/her to affect ameliorate. Controls self-denial, and allows for uninterrupted sleep and zeal amid the tolerance flatten.
Reassure parents and offshoot that junction involvement is immediate, that self-denial and edema conciliate bear, and that junctions conciliate give-back to recognized bulk. Reduces trouble cognate to fear of immutable detriment.
Educate parents in suited organization positioning and handling of fictitious compressiveness. Promotes self-satisfaction and shirks self-denial and contractures during bed intermission.


Nursing Diagnosis May be cognate to
  • Illness or irritant indisposition
Possibly indicationd by
  • Increase organization region aloft recognized stroll
  • Hot, flushed peel
  • Chills
  • Tachycardia, tachypnea
Desired Outcomes
  • Child conciliate conduct region amid the recognized stroll and be operating of chills.
Nursing Interventions Rationale
Assess region, disposition trounce, and blood hurry regularly. A region of 101°F (38.3°C) or aloft is distinguished acrave delay redness, self-denial, and swelling of the junctions; HR and BP extension as hyperthermia progresses.
Administer nonsteroidal anti-irritant refuse (NSAIDs) as prescribed; Respect for any unseasonable possessions of NSAIDs. Reduces inflammation and self-denial; Side possessions of NSAIDs may embrace abdominal self-denial, tinnitus, dizziness, headache, stomach ulcer, GI bleeding.
Administer a mode of penicillin therapy or a unmarried intramuscular dose of benzathine penicillin. A full antibiotic texture of penicillin eliminates assemblage A streptococcus taint.
Provide a tepid defend bath. Helps convert the betiderence of flush.
Modify the offshoot’s environment such as opportunity region and bed linens as implied. Room region may be accustomed to adjacent recognized organization region and blankets and linens may be adjusted as implied to organize the region of the client.
Eliminate superfluity dress and covers. Exposing peel to opportunity air retrenchs interestedth and extensions evaporative cooling.
Maintain bed intermission chiefly during the quick febrile air. Conserves air and converts metabolic trounce.
Teach offshoot and rise members environing the signs and symptoms of hyperthermia and acceleration in identifying factors cognate to the betiderence of flush; debate the avail of extensiond flowing intransfer to shirk dehydration. Providing vigor inculcateings to the enduring and rise aids in coping delay indisposition stipulation and could acceleration anticipate prefer complications of hyperthermia.

Activity Intolerance

Nursing Diagnosis May be cognate to
  • Decrease cardiac output
  • Muscle weakness
Possibly indicationd by
  • Prolonged bed intermission
  • Imposed zeal intermissionriction
  • Imbalanced oxygen afford and demand
Desired Outcomes
  • Child can composition amid the limits of tolerance for that wholly measured.
Nursing Interventions Rationale
Assess the offshoot’s disturbance and substantial zeal flatten. Provides baseline notification for formulating nursing goals during goal contrast.
Assess and evaluate nutritional vigor condition of the client. Adequate air reserves are demanded during zeal.
Monitor pulse trounce, rank hurry; respect for dyspnea, use of aider muscles, and peel tint anteriorly and succeeding zeal. Identifies the cardiopulmonary condition of the client demanded to acceleration particularize the power to toletrounce an zeal.
Provide tender foundation and decisive collocation concerning abilities. Appropriate supervision during present efforts can mend faith.
Encourage strong intermission eras in betwixt zeal. Allows optimal execution during n zeal.
Assist delay activities of daily foundation as demanded such as eating, bathing, dressing, encircleation. Decreases oxygen decline and boosts faith in performing a job.
Encourage and inculcate the offshoot delay locomotive stroll-of-motion exercises. Helps mend junction power and anticipate muscle atrophy.
Instruct offshoot to return zeal ghostly uninterruptedly asymptomatic at intermission and indicators of quick inflammation possess fixed. Help gait the offshoot’s air and afford for climax self-satisfaction.

Risk for Infection

Nursing Diagnosis May be cognate to
  • Chronic repose of indisposition
Possibly indicationd by
  • [not ry]

Acute Rheumatic Flush Nursing Preservation Plans|Desired Outcomes

  • Child conciliate cognizance an failure of betiderence of reinfection.
  • Child conciliate be afebrile; no complaints of disquiet.
  • Child conciliate transfer medications as ordered.
Nursing Interventions Rationale
Assess parents’ cognizance and skills in the government of prescribed antimicrobials; daily vocal government or monthly intramuscular injections. Providing crave-term antibiotic therapy (as crave as 5 years) as a contrariant measure may be challenging.
Monitor for chest self-denial, nonproduction of inspiration, fatigue, cough, extinction sweats, friction rub, gallop during the quick stage of the indisposition. Signs and symptoms of carditis, which may end in endocarditis causing vegetation that beseems unmanageable at the valve areas that is at extensiond betray of frequent taints.
Administer antibiotic therapy during the quick air of indisposition as prescribed. Inhibits cell forbearance body of microorganisms, destroying the efficient pathogen.
Instruct in the crave-term antibiotic nourishment, the demand for shelter antecedent dental composition or any invasive procedure, and instruct of avail to anticipate repose. Therapy begins succeeding the quick air and medical supervision is demanded for existence as rheumatic flush may recur; a proud percentage of conclusion who incur the indisposition possess cardiac complications forthcoming in existence.
Notify the physician forthafter a while for any upper respiratory taints, proud region, junction self-denial, or non-compliance to antibiotic therapy. May designate repose of the indisposition or demand to modify or adjust medication.

See Also

You may as-well approve the subjoined posts and preservation plans:

Communicable and Communicated Diseases Preservation Plans

Care plans cognate to communicable and communicated indispositions: Pediatric Nursing Preservation Plans Nursing preservation plans for pediatric stipulations and indispositions:


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