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CONCEPT AND MAPPING FOR RHEUMATIC HEART DISEASE

SUBMITTED BY: ANULAO, MICHEAL


CLEOFE, AILYNE A.
SUBMITTED TO: MRS. JANET L. GADDI
DATE: NOVEMBER 21, 2016
RHEUMATIC HEART DISEASE

PREDISPOSING FACTORS PRECIPITATING FACTORS


CAUSES:
Family History Sanitation
STRIPTOCOCCI Poor environment
GROUP A Reduced access to medical care

(strep on throat will cause


rheumatic fever, and it
leads to rheumatic heart
disease)

SIGN AND SYMPTOMS:

Fever
Chest pain
Small painless nodules or lumps under the skin
Painful and tender joints often at the ankles and knees, elbow or wrist, less often at the shoulders, hips
and feet
Pain in one joint migrates to another joint
Red, hot swollen joint
Sensation of rapid cluttering or pounding heart beat ( palpitation)
LABORATORY FINDINGS:

High ESR
Anemia, leukocytosis
Elevated C-reactive protein
ASO titre > 200 Todd units( Peak value attained at 3 weeks, then comes down to normal
by 6 weeks)
Anti-DNAase B test
Throat culture- GABH streptococci
ECG-prolonged PR interval, 2nd or 3rd degree blocks, ST depression, T inversion
2D Echo cardiography -valve edema, mitral regurgitation, LA & LV dilatation pericardial
effusion, decreased contractility.

DIAGNOSIS:

DIAGNOSIS MAY INCLUDE THE FOLLOWING:

Physical examination- while a hurt murmur may suggest RHD, many patients with RHD
do not have a murmur
Medical history including evidence of past ARF or strep infection
Chest x-ray to check enlargement of the heart or fluid on the lungs
Electrocardiogram (ECG) to check the heart have enlarged or if there is an abnormal
heart rhythm ( arrhythmia)
Echocardiogram to check the heart valves for any damage or infection and assessing if
there is heart failure. This is the most useful test for finding out RHD is present
NURSING MANAGEMENT:

PREVENTION:

Children with possible throat infection would be cultured for


strep

HOSPITALIZATION:
MEDICATION:
Children with rheumatic
fever should be Antibiotic and
Aspirin DISCHARGE PLANNING:
hospitalized
Bed rest for monitoring Recovery phase occurs at
carditis home
4 weeks bed rest if Activity limitations
carditis develops Antibiotic prescribed

TEACHING:

Reoccurrence of sore throat need for culture


Follow up care to monitor heart function