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    Rheumatic Heart Disease

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    Aica Anis
    Rheumatic fever is an autoimmune disease that can permanently damage the heart if not properly managed. It is caused by an untreated streptococcal infection which triggers an inflammatory response that attacks the heart, joints, brain and skin. Symptoms include painful joints, fever and potential long term effects like rheumatic heart disease. Treatment involves antibiotics to prevent recurrent infections along with medications and surgery to manage heart damage and symptoms like pain, shortness of breath and edema. Nurses monitor for symptoms, administer treatments and provide comfort and education to patients.

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    © All Rights Reserved
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    Rheumatic Heart Disease

    Uploaded by

    Aica Anis
    46 views15 pages
    Rheumatic fever is an autoimmune disease that can permanently damage the heart if not properly managed. It is caused by an untreated streptococcal infection which triggers an inflammatory response that attacks the heart, joints, brain and skin. Symptoms include painful joints, fever and potential long term effects like rheumatic heart disease. Treatment involves antibiotics to prevent recurrent infections along with medications and surgery to manage heart damage and symptoms like pain, shortness of breath and edema. Nurses monitor for symptoms, administer treatments and provide comfort and education to patients.

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    Rheumatic fever is an autoimmune disease that can permanently damage the heart if not properly managed. It is caused by an untreated streptococcal infection which triggers an inflammatory response that attacks the heart, joints, brain and skin. Symptoms include painful joints, fever and potential long term effects like rheumatic heart disease. Treatment involves antibiotics to prevent recurrent infections along with medications and surgery to manage heart damage and symptoms like pain, shortness of breath and edema. Nurses monitor for symptoms, administer treatments and provide comfort and education to patients.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    46 views15 pages

    Rheumatic Heart Disease

    Uploaded by

    Aica Anis
    Rheumatic fever is an autoimmune disease that can permanently damage the heart if not properly managed. It is caused by an untreated streptococcal infection which triggers an inflammatory response that attacks the heart, joints, brain and skin. Symptoms include painful joints, fever and potential long term effects like rheumatic heart disease. Treatment involves antibiotics to prevent recurrent infections along with medications and surgery to manage heart damage and symptoms like pain, shortness of breath and edema. Nurses monitor for symptoms, administer treatments and provide comfort and education to patients.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    Rheumatic Heart Fever

    (Group 1)
    Contents
    Pathophysiology

    Medication / Surgical
    Management

    Nursing Diagnosis
    and Interventions
    Rheumatic Fever

    • is an autoimmune disease
    that can affect the joints,
    brain, skin and can
    permanently damage the
    heart if not managed well.
    Precipitating factors:
    Predisposing factors: Etiology –
    Untreated throat infection by Overcrowding
    Susceptible Host
    Group A streptococcus Bacteria Poor Hygiene
    Age (5-15 yrs. old)
    Malnutrition
    Poor medical attention
    Tissue Injury
    (Throat membrane)

    Initial
    Inflammatory
    Response

    Mast cells release Increase


    histamine capillary
    permeability
    Vasodilation
    WBC Activation

    Phagocytosis

    Release of Low
    Painful Prostaglan chemical Interleukin grade
    throat din Mediators fever

    Plasma cells in the


    regional lymph node
    creates antibodies

    Auto immune complexes


    will be deposited to the
    tissues of heart, joints,
    skins, and CNS
    Further Inflammation of
    tissues (Skins, Heart,
    Joints, and CNS)

    Continuous WBC Activity

    Attacks vimentin Attacks gangliosides in


    Minimal
    in synovial the basal ganglia
    Keratin Adheres
    membrane
    damage to cardiac
    proteins
    Prostaglandin release Inc. collagen
    Erythema Sydenham’s
    + deposits in the
    Marginat Chorea
    Nerve ending stimulation subcutaneous
    um Carditis
    layer
    (The Onset Of
    RHD)
    Arthralgia Nodules
    Pericardium Fibrinoid necrosis in the Vegetations develop
    layers rub Myocardium in the valve
    (endocardium layer)
    Aschoff bodies
    Chest
    Pain Decrease Collagen deposit from
    contractility fibroblast activation

    Decrease preload Thickening of the


    Rapid/ Shortness and stroke volume valves
    Irregular Of Breath
    Pulse
    Decrease Stenosis

    Activity Cardiac Output


    Intolerance Fluid build up Heart Failure
    in the lower CHF
    extremities
    Medical /
    Surgical
    Management
    A. Medical Management
    1. The key to ARF/RHD management is secondary prevention with continuous antibiotic
    prophylaxis to prevent recurrent infection with Group A streptococcus. Benzathine penicillin G
    dosed every 3-4 weeks is superior to oral penicillin.

    2. Tab. Erythromycin 250 mg BD x 10 days (in case of penicillin allergy)


    3. Pain Reliever

    B. Surgical Management
    1. Surgical Mitral Valve Repair

    2. Percutaneous transluminal
    balloon valvuloplasty.
    Acute pain related to
    inflammation.

    Nursing Decrease cardiac output as


    evidenced by shortness of
    breath.
    Diagnosis Fluid Volume Excess as
    evidenced by edema in
    lower extremity.
    Nursing Interventions
    Dependent Nursing:
    1. Give the patient a pain reliever as prescribed by the physician.

    Independent Nursing:
    2. Assess the characteristics of pain.
    3. Provide comfort measures and a quiet environment.
    4. Provide the patient some relaxation techniques such deep slow
    breathing, distraction and assist as needed.
    5. Monitor vital signs after medication administration.
    Nursing Intervention

    Dependent Nursing:
    1. Administer medication such as digoxin as prescribed
    by the physician.
    2. Administer supplemental oxygen as prescribed by
    the physician.

    Independent Nursing:
    3. Monitor the patient’s heart rate and blood pressure.
    4. Assist the patient into a semi fowler’s position for
    decreased cardiac workload.
    5. Assist the client when needed.
    Nursing Intervention

    Dependent Nursing:
    1. Give diuretics as prescribed by the physician.

    Independent Nursing:
    2. Monitor the input and output of the patient.
    3. Limit the intake of fluid as necessary.
    4. Assist the patient when voiding.
    5. Assist in repositioning every 2 hours to facilitate
    fluid evacuation in the lower extremity.
    References:
    Hockenberry M, Wilson D, Rogers C, (2019). Wong’s Nursing Care of Infants and
    Children 2nd Philippine Edition. Acute Rheumatic Fever and Rheumatic Heart Disease.
    Singapore. Elesevier 2019. Vol .2 pp 996-997

    Doenges M, Moorhouse M, Murr A, (2020). Nurse Pocket Guide. Philadelphia. E.A


    Davis, 2020. pp9-7, 505-511, 36-42.

    Mirabel, M; Celermajer, DS; Jouven, X (2012). "Rheumatic heart disease". Lancet.


    379 (9819): 953–64. doi:10.1016/S0140-6736(11)61171-9. PMID 22405798. S2CID
    20197628.

    https://www.grepmed.com/images/8195/rheumatoidarthritis-pathophysiology-sign
    s-symptoms-diagnosis

    https://www.youtube.com/watch?v=aun61Xq8G3g&t=1705s

    https://www.youtube.com/watch?v=EB5zxdAQGzU
    Thank you.

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