Signs and symptoms Book Based

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Client Based
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Chest pain Heart palpitations Breathlessness exertion on

Easy fatigability Heart palpitations

Breathing problems when lying down (orthopnea) Walking from sleep with the need to sit or stand up (paroxysmal nocturnal dyspnea) Swelling (edema) Fainting (syncope) Stroke Fever associated with infection of damage heart valves

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The signs and symptoms that may be observed to the client with RHD are easy fatigability and heart palpitations. The client wasn’t able to finish half of his work due to his easy fatigability. Risk Factors Book Based    Poverty Overcrowding Reduced access medical care  to Client Based Reduced access medical care to

Diagnostic test You may notice the signs of RHD and decide to visit your doctor. The doctor may order Physical examination – while a heart murmur may suggest RHD. Chest x-ray – to check for enlargement of the heart or fluid on the lungs. . Tests will be carried out to reach a diagnosis and determine the appropriate course of treatment.The factor that may contribute the development of RHD is reduced access to medical care. the treatment for the disease was delayed and some discomforts were experienced by the client. If a doctor suspects the patient has RHD they may refer them to a specialist cardiologist. Echocardiogram – to check the heart valves for any damage or infection and assessing if there is heart failure. The earlier the condition is diagnosed the lower the risk of complications. This is the most useful test for finding out if RHD is present. As a result. Medical history – including evidence of past ARF or strep infection. Electrocardiogram (ECG) – to check if the chambers of the heart have enlarged or if there is an abnormal heart rhythm (arrhythmia). many patients with RHD do not have a murmur.

of certain Recurrent pulmonary infections (restraining organism in the respiratory system) . the mural endocardium. (preventive) antibiotic group A streptococcus throat infection and recurring ARF.Complication Rheumative complications. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened). As a result. Some people believe: Regular check-up with a cardiologist to monitor the heart. . heart When it failure does. or a septal defect. these (RHD) rarely has complications include: Arrhythmia (An irregular heartbeat is an arrhythmia (also called dysrhythmia). Heart rates can also be irregular). Congestive heart failure ( blood moves through the heart and body at a slower rate. Infective endocarditis ( an infection of the endocardial surface of the heart. Up-to-date Regular flu (influenza and pneumococcal) to prevent vaccinations. the heart cannot pump enough oxygen and nutrients to meet the body's needs. and pressure in the heart increases. which may include one or more heart valves.Death (the cessation of all biological functions that sustain a living organism) Prevention The Rheumative heart disease cab be prevented.

as pregnancy can make rheumatic heart disease worse (www. and where appropriate. antibiotic treatment of sore throats.e. administer oxygen at concentration to maintain Pao2 at acceptable level i. Antibiotics. follow ABG levels/Sa02 to determine oxygen need and response to oxygen therapy. worsening hypoxia indicating condition.emedicinehealth. For reducing fever: do tepid . Good dental hygiene (tooth brushing and flossing.Early presentation. 4 to 6. Good prenatal care. place patient in an upright position to obtain greater lung expansion and improve Nursing Management The following are the nursing management that can be done for a client with rheumatic heart Disease: for for ineffective dyspnea. ambulate as tolerated) should be employed. Frequent turning and increased activity (up in chair. dental check-ups)as oral bacteria entering the bloodstream can increase the risk of complications such as inflammation of the inner lining of the heart. diagnosis. breathing and pattern: confusion Observe cyanosis.may be given to some people before some dental or surgical procedures to prevent bacterial infection of the damaged areas of the heart.

Usually aspirin is given in large doses until the joint inflammation goes away. need Once to the take acute illness or has an gone away. steroids are needed. reduce pain. Maintaining cardiac output: assess for signs and symptoms of acute rheumatic carditis.sponging to reduce and fever through conduction and evaporation administer antipyretic. monitor for tachycardia (usually persistent when patient sleeps) or bradycardia. and/or precordial tightness. rarely. patients penicillin. equivalent . administer penicillin therapy as prescribed to eradicate hemolytic streptococcus. sounds every 4hours. palpitations. give salicylates or NSAIDs as prescribed to suppress rheumatic to activity fever by and controlling to relieve toxic joint manifestations. be alert to patient’s complains of chest pain. Medical Management Treatment of acute rheumatic fever includes antibiotics to treat the strep infection and additional medications to ease the inflammation of the heart and other symptoms. be alert to development of second-degree (acute heart block or wenckebach’s pulse rate disease interval rheumatic carditis auscultate causes heart prolongation).

in which case it must be replaced by an artificial valve. for many years to prevent recurrences. surgery may be needed to eliminate the leak. This is a very important treatment because the risk of heart valve damage increases if rheumatic fever recurs. Surgical Management Most often the valve leak caused by the disease is mild and does not need treatment. . If the leak is severe enough to strain and enlarge the heart. This surgery may involve repair of the damaged valve.antibiotic. Sometimes the valve is too badly damaged to repair.