Page 1071 - Saunders Comprehensive Review For NCLEX-RN

6. Administer pain medications as prescribed.
7. Administer antibiotics and antipyretics as prescribed.
8. Promote rest and sleep periods.
9. Facilitate parent-child contact as soon as possible.

B. Postoperative home care (Box 36-5)

X. Rheumatic Fever
A. Description
1. Rheumatic fever is an inflammatory autoimmune
disease that affects the connective tissues of the heart,
joints, skin (subcutaneous tissues), blood vessels, and
central nervous system.
2. The most serious complication is rheumatic heart
disease, which affects the cardiac valves, particularly
the mitral valve.

3. Rheumatic fever manifests 2 to 6 weeks after

an untreated or partially treated group A beta-
hemolytic streptococcal infection of the upper
respiratory tract.
4. Jones criteria are used to help determine the diagnosis
(Box 36-6).

B. Assessment (Fig. 36-1)

1. Fever: Low-grade fever that spikes in the late
afternoon
2. Elevated anti–streptolysin O titer
3. Elevated erythrocyte sedimentation rate
4. Elevated C-reactive protein level
5. Aschoff bodies (lesions): Found in the heart, blood
vessels, brain, and serous surfaces of the joints and
pleura

Assessment of a child with suspected rheumatic fever includes

inquiring about a recent sore throat, because rheumatic fever manifests
2 to 6 weeks after an untreated or partially treated group A beta-
hemolytic streptococcal infection of the upper respiratory tract.

C. Interventions

1. Assess vital signs.
2. Control joint pain and inflammation with massage and
alternating hot and cold applications as prescribed.
3. Provide bed rest during the acute febrile phase.
4. Limit physical exercise in a child with carditis.
5. Administer antibiotics as prescribed.
6. Administer salicylates and antiinflammatory agents as

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