Assessment Nursing Scientific Explanation Objectives Interventions Rationale Expected Outcome

Diagnosis

Objective: Risk for Rheumatic fever is an Short term  Independent  Independent Short Term:
infection related autoimmune disease in which
 Past medical to recurrence of the recurrence of it is high if After 1-2 days of 1. Identify the parents’ 1. This would help After 1-2 days of nursing
History: patient a disease as the patient has had history of nursing interventions, knowledge on identify if further interventions the parents
experienced evidenced by GAS pharyngitis and parents of the patient recurrence of infection teaching is needed of the patient shall have:
group A past medical rheumatic fever. The will be able to or rheumatic fever. and know what topic
Streptococcus pha should be given 1. Verbalized adequate
history of GAS probability of acquiring this 1. State full 2. Assess for presence of understanding of the
ryngitis pharyngitis and condition again is at the emphasis.
understanding risk factors that could preventive measures
 Major criteria presence of highest during the first few regarding the predispose the patient 2. Factors that are reinfection such as
major and minor years after the initial attack. prevention of to reinfection such as present will be given adhering to the
- Joint pain (pain in his criteria like joint According to the signs and recurrence like previous history of attention and proper treatment regimen
knees, elbows, pain and fever symptoms previously taking the noncompliance to the nursing management by taking the given
shoulders, and neck) secondary to experienced by the patient, medications as treatment regimen. especially on health medications as
rheumatic fever. two are included in the major prescribed education. prescribed.
- Subcutaneous 3. Educate the parents of
criteria while there are 4
Nodules 2. Verbalize the the patient about the 3. Avoids reinfection 2. Stated the signs and
minor criteria presented
 Minor criteria which further increases the signs and early signs and because medical symptoms of
risk of recurrence acute symptoms of symptoms of reinfection attention will be recurrence of
- Fever rheumatic fever in this reoccurring of the that they should immediately given. infection in which
patient. Furthermore, due to disease such as immediately notify their they should
- Arthralgia (10/10 pain 4. Providing long-term
this high risk of getting joint pain and health care providers immediately report to
scale) antibiotic therapy (as
infected again by the GAS fever. such as fever and joint their attending
pain. long as 10 years) as a physician such as
- Increased Erythrocyte bacteria, the patient is
Long term: preventive hyperthermia and
sedimentation rate (93  recommended to continue
4. Assess parents’ measure may be arthralgia.
mm/hr) secondary prophylaxis with 1. After 7 days of knowledge and skills in challenging.
penicillin G benzathine every nursing
*normal pediatric ESR: the administration of
4 weeks for the next 10 years interventions, 5. Carditis, may
0-10mm/hr prescribed
in order to prevent patient will be able increased risk of Long Term:
antimicrobials.
complications such as heart to have normal recurrent infections.
- Increased C-reactive
failure if rheumatic fever is temperature(Axialli 1. After 7 days of
protein level (84.3  5. Closely monitor the
not properly treated ary: 36.5°C to 6. a normal pulse rate is nursing
mg/L) patient for signs and
immediately. a valuable sign for interventions, the
37.2°C) and be symptoms of shortness
*Normal: <10 mg/L improvement and a patient shall have
Source: free from pain of breath, chest
normal apical pulse acquired normal
(1/10 pain scale) pain, fatigue, night
 Evidence of indicates inflammation body temperature
Acute Rheumatic Fever: sweats, cough, friction
Recent GAS 2. After 10 years of is decreasing and the and verbalized being
Information For Clinicians | rub, gallop during the
infection treatment, the child’s heart action is free from pain.
CDC. (2018, July 12). CDC. acute stage of the
patient will be able improving which
- Elevated https://www.cdc.gov/groupast disease. 2. After 10 years of
to experience an decreases the
Antistreptolysin O titers rep/diseases-hcp/acute- absence of 6. Closely monitor vital chances of reinfection. medical treatment,
(4,133 IU/ml) rheumatic-fever.html occurrence of signs especially the the patient shall
reinfection. pulse rate and obtain 7. Normal WBC, ESR have not experience
*Normal:<200IU/ml apical pulse for 1 full and CRP indicates the recurrence of
minute while the child is improvement on the reinfection.
awake and asleep. child’s condition and if
these are elevated, a
7. Monitor the laboratory change in the medical
results. approach would be
managed.
8. Encourage the patient
to be on bed rest until 8. Resting would
signs and symptoms promote faster
are absent or values recovery period.
are back to normal
9. Drug resistance would
9. Discuss to the patient be prevented
the importance of not
taking left over
antibiotics and following  Dependent
the full treatment
regimen. 1. For CBC, urinalysis,
blood, urine, and
throat culture and
 Dependent other laboratory tests
to determine if
1. Get blood, urine and interventions are
mucus sample for effective and no signs
laboratory tests. of reinfection are
present.
2. Provide prescribed
antibiotics. 2. Doing so will prevent
the recurrence of
infection.
 Interdependent  Interdependent
1. Collaborate with 1. For proper nutrition
nutritionist and diet of the client to
2. Collaborate with promote proper growth
counselors. and development of
the child

2. Helps the family cope

with mental and
emotional stress due
the child’s condition
especially it requires
long-term treatment.