rheumatic fever1_1_2.pptx

V
NARAINA NURSING COLLEGE,
PANKI, KANPUR
SUBJECT – CHILD HEALTH NURSING
PRESENTATION ON – RHEUMATIC FEVER
Presented by –
Vishwa pratap singh,
Bsc nursing , 4th year
DEFINITION
It is a non-supurative sequela of Group A, ß-
hemolytic streptococcal (GABHS) throat
infection. The disease involves the joint (hence
the word “rheumatic”), heart, skin,
subcutaneous tissue and the brain.
RHEUMATIC FEVER is a multisystem disease. It
is caused by bacterium called Group-A Beta
hemolytic streptococcal(GAS).
EPIDEMIOLOGY
 Rheumatic fever is a major cause of acquired heart
disease in children world wide, with the disease
occurring most frequently in underdeveloped countries
where access to medical care is limited and children live
in poverty and unsanitary crowded conditions.
 The incidence rate 4-5/1000 among the children of age
group 4-15 years.
RISK FACTOR
1. Age and sex: - Children between 04-15 years of age are
affected more commonly. First attack of acute rheumatic
fever is rare in children < 3 years.
2. Socioeconomic status: - Rheumatic fever is common in
areas of high poverty, poor living conditions and Over
crowded and unsanitary. living conditions.
3. Season: - Rainy season.
4. Genetic : Due to consanguine marriage.
5. Poor nutrition
PATHOGENESIS
Risk factor
Susceptible Host
GABHS
GABHS producing m-protein
which is similar to host
protein
This m-protein cross
react with host cell
Cross reaction induce
inflammation (joints,
heart, brain, skin)
Symptoms appear
Remark –
The exact
mechanism
streptococcal throat
infection results in
rheumatic fever is
unknown.
CLINICAL FEATURES
Major criteria
1.Carditis - Pericarditis , myocarditis , endocarditis. Murmur
sound.
2.Polyarthritis - It is inflammation of joints with sever pain,
decreased activity, mostly knee and elbow joints.
3.Chorea - involuntary rapid movements, muscle weakness,
impaired coordination of facial muscle , speech
disturbance.
4.Subcutaneous nodule - Painless nodule over the extensor
surface of joints.
5.Erythema marginatum - It is pink macular non-itching
rash , found over the trunk, extremities but never on
face.
MINOR CRITERIA
1.Fever- more than 39.5 C.
2.Arthralgia – pain in joints. Approx in 90% cases.
Other features
Abdominal pain
Headache
Fatigability
General weakness
Tachycardia
Malaise
Sweating
Vomiting
Skin rashes
Erythema
Epistaxis
Anemia
Pleuritis
Weight loss
01 Initial episode of
rheumatic fever
Two/one major and two minor features
+ evidence of a preceding GABHS
02 Recurrent attack Two/one major and two/three minor
features + evidence of a preceding
GABHS
DIAGNOSTIC EVALUATION
Investigation
• Echocardiogram
• Artificial subcutaneous nodule test
• Endomyocardial biopsy
• Chest X-ray
• ECG
• Blood test
• Swab culture
Assessment
Medical management
• Bed rest for at least 6 to 8 weeks.
• Nutrition .
Management
Sr. Drug Dose Route Frequency Action
01 Procaine
penicillin
4 lakh
unit
IM BD Antibiotic
02 Aspirin 120mg/
kg
Orally OD NSAID
03 Prednisolone 60mg orally OD Steroid
NURSING MANAGEMENT
Nursing diagnosis
Increased body temperature related to infection as
evidenced by patient.
Nursing interventions
 Assess the vital sign of the patient.
 Provide comfortable environment.
 Provide sponge bath to the patient.
 Provide cool and calm environment.
 Administer antipyretic drug.
NURSING MANAGEMENT
Nursing diagnosis
Inability to move related to joint pain as evidenced by
physical examination.
Nursing interventions
 Assess the vital sign of patient.
 Assess the level of pain , site, frequency.
 Provide comfortable position.
 Administer analgesic as prescribed by doctor.
 Provide physical therapy.
 Frequently assess the patient condition.
BIBLIOGRAPHY
 Rimple Sharma, essential of pediatric nursing, edition
3rd 2021, published by jaypeebrothers medical
publisher, page no. 251-252.
 Parul datta, pediatric nursing, edition 5th 2022,
published by jaypeebrothers medical publisher, page
no. 306-307.
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rheumatic fever1_1_2.pptx

  • 1. NARAINA NURSING COLLEGE, PANKI, KANPUR SUBJECT – CHILD HEALTH NURSING PRESENTATION ON – RHEUMATIC FEVER Presented by – Vishwa pratap singh, Bsc nursing , 4th year
  • 2. DEFINITION It is a non-supurative sequela of Group A, ß- hemolytic streptococcal (GABHS) throat infection. The disease involves the joint (hence the word “rheumatic”), heart, skin, subcutaneous tissue and the brain. RHEUMATIC FEVER is a multisystem disease. It is caused by bacterium called Group-A Beta hemolytic streptococcal(GAS).
  • 3. EPIDEMIOLOGY  Rheumatic fever is a major cause of acquired heart disease in children world wide, with the disease occurring most frequently in underdeveloped countries where access to medical care is limited and children live in poverty and unsanitary crowded conditions.  The incidence rate 4-5/1000 among the children of age group 4-15 years.
  • 4. RISK FACTOR 1. Age and sex: - Children between 04-15 years of age are affected more commonly. First attack of acute rheumatic fever is rare in children < 3 years. 2. Socioeconomic status: - Rheumatic fever is common in areas of high poverty, poor living conditions and Over crowded and unsanitary. living conditions. 3. Season: - Rainy season. 4. Genetic : Due to consanguine marriage. 5. Poor nutrition
  • 5. PATHOGENESIS Risk factor Susceptible Host GABHS GABHS producing m-protein which is similar to host protein This m-protein cross react with host cell Cross reaction induce inflammation (joints, heart, brain, skin) Symptoms appear Remark – The exact mechanism streptococcal throat infection results in rheumatic fever is unknown.
  • 6. CLINICAL FEATURES Major criteria 1.Carditis - Pericarditis , myocarditis , endocarditis. Murmur sound. 2.Polyarthritis - It is inflammation of joints with sever pain, decreased activity, mostly knee and elbow joints. 3.Chorea - involuntary rapid movements, muscle weakness, impaired coordination of facial muscle , speech disturbance. 4.Subcutaneous nodule - Painless nodule over the extensor surface of joints. 5.Erythema marginatum - It is pink macular non-itching rash , found over the trunk, extremities but never on face.
  • 7. MINOR CRITERIA 1.Fever- more than 39.5 C. 2.Arthralgia – pain in joints. Approx in 90% cases. Other features Abdominal pain Headache Fatigability General weakness Tachycardia Malaise Sweating Vomiting Skin rashes Erythema Epistaxis Anemia Pleuritis Weight loss
  • 8. 01 Initial episode of rheumatic fever Two/one major and two minor features + evidence of a preceding GABHS 02 Recurrent attack Two/one major and two/three minor features + evidence of a preceding GABHS DIAGNOSTIC EVALUATION Investigation • Echocardiogram • Artificial subcutaneous nodule test • Endomyocardial biopsy • Chest X-ray • ECG • Blood test • Swab culture Assessment
  • 9. Medical management • Bed rest for at least 6 to 8 weeks. • Nutrition . Management Sr. Drug Dose Route Frequency Action 01 Procaine penicillin 4 lakh unit IM BD Antibiotic 02 Aspirin 120mg/ kg Orally OD NSAID 03 Prednisolone 60mg orally OD Steroid
  • 10. NURSING MANAGEMENT Nursing diagnosis Increased body temperature related to infection as evidenced by patient. Nursing interventions  Assess the vital sign of the patient.  Provide comfortable environment.  Provide sponge bath to the patient.  Provide cool and calm environment.  Administer antipyretic drug.
  • 11. NURSING MANAGEMENT Nursing diagnosis Inability to move related to joint pain as evidenced by physical examination. Nursing interventions  Assess the vital sign of patient.  Assess the level of pain , site, frequency.  Provide comfortable position.  Administer analgesic as prescribed by doctor.  Provide physical therapy.  Frequently assess the patient condition.
  • 12. BIBLIOGRAPHY  Rimple Sharma, essential of pediatric nursing, edition 3rd 2021, published by jaypeebrothers medical publisher, page no. 251-252.  Parul datta, pediatric nursing, edition 5th 2022, published by jaypeebrothers medical publisher, page no. 306-307.