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20 Cards in this Set

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  • Back
Whats the most significant damage that rf can cause?
damage to mitral heart valve
S/S of rf usually present in what time frame after initial strep infection?
2 to 6 weeks after strep infection
RF is considered an inflammatory multisystem disease that can affect the _____, _____, ______, & ______.
heart, joints, cns, & subq tissue
Initial group of non-specific symptoms occuring with Rhuematic heart disease?
Gradual onset of low grade fever, malaise, weight loss. Then moves to high fever >100.4- can be normal in day & peak at night; history of strep in past 2-6 wks
Jones Criteria for dx RHD requires how many of what type symptom?
2 major or 1 major and 2 minor
Jones Criteria for Major diagnosis are one of which 4?
Carditis, Polyarthritis, Erythema marginatum, and Subcutaneous nodules
S/S of carditis include?
new or unchanged murmur, friction rub, EKG changes, muffled heart sounds, prolonged PR interval, minor heart enlargement on CXR with or without heart failure
S/S of polyarthritis include?
Mainly the larger joints involved, after 1-2 days other joints affected, but not in fingers. Painful red hot swollen tender joints and WILL NOT move.
What is one of the most impt psychosocial aspects of RHD and polyarthritis?
Will not be perm, crippling, disfiguring.. Will go away in about a month
S/S of Erythema marginatum?
Non-itching red circular migratory transient rash on torso and can be brought out by heat, has clear, pale to yellow center. Rare but classic sign.
S/S of subcutaneous nodules?
usually over bony prominences, non-tender freely moveable bebe's.
What is Chorea?
benign involuntary purposeless jerking twitching in trunk that occurs with muscle weakness.
What are classed as the minor Jones Criteria diagnosis?
Fever, arthralgia, previous RF or evidence of preexisting RHD
Common labs are: WBC's, SED rate, and abnormal C reactive protein- what are their findings?
WBC's are increased, SED rate is way up (norm 0-10) find in 90's, C reactive protein rises with infection and decreases with meds.Is not normally found and is sensitized by liver.
What are treatment goals?
Elim hemolytic strep, prevent cardiac damage, relieve other symptoms and prevent recurrance.
Drug of choice for RHD?
Penicillin's- Augmentin b/c of the batalactam that has added acid to break through batalactam ring to let penicillin in.
Other necessary nursing interventions for RHD?
strict bed rest til afebrile, salicylates & NSAID's, NO ASA- ensure compliance, teaching activity levels, meds, dr follow ups
When treating with salicylates, what is a possible problem?
can mask inflammation and prolong duration- try to use NSAID's and poss codiene
What is done for 6 months post infection (neg throat culture) & treatment?
Prophylactic antibiotics, testing c reactive protien and sed rate once per month.
What is one thing you do not do which will limit the pain in joints?
No passive or active ROM, tell them not to move it and possible consult with PT