1. What is the highlight or conclusion of the article?

Rheumatic heart disease (RHD) continues in

the 21st century in countries with low and middle incomes, as well as in vulnerable communities
in countries with high incomes, particularly indigenous people. Increased maternal morbidity
and mortality, weaker perinatal results and compromise treatment pathways are linked with
RHD during pregnancy. Heart and rheumatic mitral disease occur in 2–4% of pregnancies.
Pregnancy's most common heart condition acquired. When there is a maternal heart defect,
changes in the blood of the pregnant mother and/or fetus may result in decompensation or
death. According to journal, cardiovascular disorder renders all pregnancies 1% to 3% difficult,
and constitutes 10% to 15% of maternal mortality. Around 90 percent of all cardiovascular
disease among females in low incomes countries accounts for Rheumatic Heart Disease (RHD).
RHD is a young disease that has an effect on reproductive women. An initial diagnosis is made in
some women, either antenatal or postpartum, when they do not tolerate the symptoms of
hormonal pregnancy changes, inducing clinical decompensation. The higher incidence of
antenatal hospital admission and about 50% mortality, most frequently occurring in the
postpartum, was associated with symptomatic mitral stenosis. Although pregnancy is indolent
for most women, it poses particular difficulties for RHD women. In addition to the effect of
pregnancy and delivery on the heart, the impact of RHD therapy on the fetus must also be
addressed. There may be teratogenic treatments, while surgical therapy may raise the risk of
pregnancy failure. Furthermore, involved pregnant women living with rheumatic heart disease
who were either undergoing antenatal therapy or cardiology ambulatory clinics. Rheumatic
heart disease, including electrocardiography (ECG) and echocardiography conducted at the
Department of Cardiology, was diagnosed in terms of the clinical history of long-acting penicillin
or cardiac complications prior to birth. Early preconception assessment and guidance must be
given to women with RHD of reproductive age about the possible cardiovascular consequences
of pregnancy. Many who want to think or present after conception must use an MDT to
recognize and prevent the fetal anomaly/loss causes during pregnancy and puerperium.

During pregnancy, women with rheumatic heart disease increases blood volume resulting in increased
pressure on the heart valves which increases maternal risks. Preexisting cardiac disease is a major
contributor to maternal mortality globally, particularly in low- and middle-income countries. Rheumatic
fever and RHD thrive in squalid conditions and in regions with poor public health systems. Prevention is
cheap, readily available, and cost-effective.

2. Based on the journal, how can these information most likely to help in improving nursing care or
management to the pregnant patients? Give examples and explain In these types of cases about
rheumatic heart disease which becomes fatal to the mother and the child. More pregnant
women are asymptomatic of this type of disease that will suddenly have cardiac arrest which we
know is one of the treacherous diseases is heart disease. If others think it is normal but over
time it can cause serious conditions that will bring undesirable news. This journal can help
nursing care management where it gives every importance that rheumatic heart disease brings
to pregnant women in the signs that it may have. There are times when you do not know where
you came from and why you have this disease, so with the help of this journal there is additional
knowledge that what else can cause rheumatic heart disease and why it usually occurs in
pregnant women in poor health. NCM further promotes more knowledge on these types of
diseases so that those who want to know why it becomes fatal to pregnant women have
 immediate digestion and maintain continuous knowledge so that when the day comes with
those who want ask this kind of disease, you are complacent that you know what you are saying
and can convey to them knowledge

Based on the journal, the information that I have gathered helped me in improving nursing care
management for patients that have Rheumatic Heart Disease by implementing close supervision to
monitor her health. I can also do health teaching that can reduce stress, such as breathing exercises.
Talking to the family of the patient to give her support since patient who have Rheumatic Heart Disease
might be suffering emotionally.

3. 3. On your OWN thoughts, describe your role and the benefits that it may serve you as a nursing
student and as a future nurse in relation to the findings of the journal. **Please sit the reference
and link of the journal and use PDF File for your answer on the guide questions. One of the
serious diseases that a nursing student can study is about the heart, what complications it can
have. The heart is one of the most delicate organs that a person has so there are many causes
that can cause heart disease. In pregnant women who have rheumatic heart disease one needs
to be monitored and kept in check for the condition so as to maintain the safety of their health
from the mother and even her unborn baby as it does not cause fatality. As a future nurse even
though it is complicated to study but I am confident in this journal and in future studies I will
learn to find out why it happens in pregnant women. As a nursing student, my knowledge is not
yet complete but I make sure that I continue to increase my knowledge of the causes of heart
disease in people especially in pregnant women. Sometimes it is confusing and jargon of words
about this disease but I can also master it because these types of studies are not a joke, I as a
future nurse do not have the skills I can cure and cure those with these types of the disease but
because I have knowledge of this type of disease, I can share it so that there is no confusion my
patient can be and the doctor can see how competent I am as a nurse

Reading journals or articles online is really helpful for me as a nursing student and as a future nurse
especially that we are in our own houses doing online school. These articles provides us students
additional information that can be useful in the future when we are now in our duty. These articles also
provided us some other perspective from other countries on what they have experienced when they
handled these patients who have this kind of diseases which later on gave them opportunity to make a
research about it or create an article about it in order for us nursing students to have more idea.
Personally, after reading these articles I have gained knowledge and ideas on how I will be able to
manage and give nursing care to these patients when I encounter this kind of situations in the future.

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122884/